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Collapsing glomerulopathy in 19 patients with systemic lupus erythematosus or lupus-like disease.

Publication ,  Journal Article
Salvatore, SP; Barisoni, LMC; Herzenberg, AM; Chander, PN; Nickeleit, V; Seshan, SV
Published in: Clin J Am Soc Nephrol
June 2012

BACKGROUND AND OBJECTIVES: Collapsing glomerulopathy is a podocytopathy with segmental or global wrinkling and collapse of capillary walls and overlying epithelial cell proliferation. Idiopathic collapsing glomerulopathy is a distinct clinicopathologic entity with significant proteinuria, poor response to immunosuppressive therapy, and rapid progression to renal failure. Collapsing glomerulopathy is associated with viral infections, autoimmune disease, and drugs. This work presents the largest group of collapsing glomerulopathy in patients with SLE. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Clinicopathological features were retrospectively studied in 19 patients with SLE (16 patients) or SLE-like (3 patients) disease with collapsing glomerulopathy. RESULTS: Initially, 95% of patients had nephrotic syndrome with proteinuria of 3-12 g per 24 hours, creatinine levels of 0.6-9.6 mg/dl, positive lupus serologies, and normal complement levels in 63%. Segmental and/or global collapsing glomerulopathy was seen in 11%-77% of glomeruli. Tubular atrophy with focal microcystic changes and interstitial fibrosis was seen in 35% of patients. Minimal glomerular mesangial deposits were noted in 63% of patients, and extensive foot process effacement was seen in 82% of patients. Initial treatment was with pulse/oral steroids. Follow-up from 13 patients revealed that 7 patients progressed to ESRD at the time of biopsy up to 21 months later, 1 patient returned to normal creatinine (1.1 mg/dl) without proteinuria, and 5 patients had creatinine of 1.2-3.6 mg/dl with proteinuria of 0.37-4 g per 24 hours. CONCLUSIONS: Collapsing glomerulopathy may be seen in SLE patients presenting with massive proteinuria with or without lupus nephritis, which may have prognostic significance.

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Published In

Clin J Am Soc Nephrol

DOI

EISSN

1555-905X

Publication Date

June 2012

Volume

7

Issue

6

Start / End Page

914 / 925

Location

United States

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Treatment Outcome
  • Time Factors
  • Steroids
  • Retrospective Studies
  • Pulse Therapy, Drug
  • Proteinuria
  • Nephrotic Syndrome
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Salvatore, S. P., Barisoni, L. M. C., Herzenberg, A. M., Chander, P. N., Nickeleit, V., & Seshan, S. V. (2012). Collapsing glomerulopathy in 19 patients with systemic lupus erythematosus or lupus-like disease. Clin J Am Soc Nephrol, 7(6), 914–925. https://doi.org/10.2215/CJN.11751111
Salvatore, Steven P., Laura M. C. Barisoni, Andrew M. Herzenberg, Praveen N. Chander, Volker Nickeleit, and Surya V. Seshan. “Collapsing glomerulopathy in 19 patients with systemic lupus erythematosus or lupus-like disease.Clin J Am Soc Nephrol 7, no. 6 (June 2012): 914–25. https://doi.org/10.2215/CJN.11751111.
Salvatore SP, Barisoni LMC, Herzenberg AM, Chander PN, Nickeleit V, Seshan SV. Collapsing glomerulopathy in 19 patients with systemic lupus erythematosus or lupus-like disease. Clin J Am Soc Nephrol. 2012 Jun;7(6):914–25.
Salvatore, Steven P., et al. “Collapsing glomerulopathy in 19 patients with systemic lupus erythematosus or lupus-like disease.Clin J Am Soc Nephrol, vol. 7, no. 6, June 2012, pp. 914–25. Pubmed, doi:10.2215/CJN.11751111.
Salvatore SP, Barisoni LMC, Herzenberg AM, Chander PN, Nickeleit V, Seshan SV. Collapsing glomerulopathy in 19 patients with systemic lupus erythematosus or lupus-like disease. Clin J Am Soc Nephrol. 2012 Jun;7(6):914–925.

Published In

Clin J Am Soc Nephrol

DOI

EISSN

1555-905X

Publication Date

June 2012

Volume

7

Issue

6

Start / End Page

914 / 925

Location

United States

Related Subject Headings

  • Young Adult
  • Urology & Nephrology
  • Treatment Outcome
  • Time Factors
  • Steroids
  • Retrospective Studies
  • Pulse Therapy, Drug
  • Proteinuria
  • Nephrotic Syndrome
  • Middle Aged