CLINICAL AND MORPHOLOGICAL CHARACTERISTIC OF LUPUS GLOMERULONEPHRITIS WITH GLOMERULAR EXTRACAPILLARY PROLIFERATION
Objective. To evaluate the effect of glomerular extracapillary proliferation and its severity on the clinical and morphological indices and the prognosis of lupus glomerulonephritis.
Materials and methods. Sixty seven cases of lupus glomerulonephritis confirmed on kidney biopsy were analyzed. The morphological method using light and immunofluorescence microscopy, morphometric and statistical methods were applied.
Results. Extracapillary proliferation in glomeruli was detected in 46.3% of cases. The patients were divided into two groups taking into account presence or absence of crescents in the glomeruli. Groups of patients with crescents in glomeruli and with no crescents differed significantly in the proteinuria levels (U=394.5, р=0.040) and the indices of decreased renal function (urea (U=303.5, р=0.001), creatinine (U=397.0, р=0.043), glomerular filtration rate (U=339.5, р=0.009)). There were no differences by the crescent score value in the laboratory and morphological parameters, including those characterizing the severity of the glomerular and interstitial sclerotic changes. At the same time it was shown that in cases with the crescent score £0.5, the chance of renal function recovery was 8.4 times higher than at the crescent score >0.5 (95% CI 1.29-54.84).
Conclusion. Evaluation of extracapillary proliferation in renal glomeruli in lupus glomerulonephritis calculating the crescent score is important for predicting the renal function. Still, further studies on the individual selection of immunosuppressive treatment are required.