lupus nephritis

description
Lupus nephritis is an inflammation of the kidney caused by systemic lupus erythematosus (SLE), an immune system disease. Outside the kidney, LED can also damage the skin, joints, nervous system and organs virtually any system or in the body.
causes
The mechanisms involved in the genesis of renal histological lesions still remain controversial. [3] This lies mainly in the fact that the elementary lesions of lupus nephritis are extremely polymorphous. However, it now recognizes three possible mechanisms: intrarenal deposits (mainly glomerular) of circulating immune complexes; renal attack by autoantibodies recognizing renal antigens or circulating antigens that are attached to the glomerular and vascular walls; vascular microthrombi due to the presence of antiphospholipid antibodies.
In the first two cases, intrarenal inflammation is caused by recruitment of complement proteins and Immunotherapy inflammatory recognizing the Fc portion of immunoglobulins registered in the renal parenchyma.
The characterization of antigenic target autoantibodies involved in lupus nephritis has highlight pathogenic autoantibodies having cross-reactivity with glomerular constituents such laminin or heparan sulfates or recognizing nucleosome fixed on the glomerular membrane. Finally, true vasculitis intrarenal are sometimes observed, secondary to poorly characterized autoantibodies, close endothelial antiImmunothérapie antibodies or ANCA.
symptoms
General symptoms of lupus include: malar rash, discoid rash, photosensitivity, oral ulcers, non-erosive arthritis, pleuropericarditis, kidney disease, neurological and hematological disorders manifestaions.
Clinically, SLE is manifested by the loss Fever weight (100%), arthralgia, synovitis, arthritis (95%), pleurisy, pericarditis (80%), Malar facial erythema, photodermatoses, alopecia (75 %), anemia, leukopenia, thrombocytopenia, thrombosis (50%).
About half of SLE cases show signs of lupus nephritis at one time or another. Kidney-specific signs: Proteinuria (100%), nephrotic syndrome (55%), granular casts (30%), red cell casts (10%), microscopic hematuria (80%), macrohématurie (2%), reduces renal function (60%), RPGN (30%), ARF (2%), hypertension (35%), hyperkalemia (15%), tubular abnormalities (70%).
Histology I, Scene (minimal mesangial) the disease appears normal by light microscopy, but the mesangial deposits are noted by electron microscopy. In this stage the analysis is typically normal urine.
Stage II (mesangial proliferative) is denoted by hypercellularity and mesangial matrix expansion. Microscopic hematuria with or without proteinuria can be seen. Hypertension, nephrotic syndrome and acute renal failure are rare at this stage.
Stage III disease (lupus nephritis focus) is indicated by sclerotic lesions <50% of glomeruli, which may be segmental or global and active or chronic, with or Extracapillary endocapillary proliferative lesions. Electron microscope, the subendothelial deposits are noted, and some mesangial changes may be present. Immunofluorescence reveals called "Full House" spot, stain positively for IgG, IgA, IgM, C3 and C1q. "Clinically, hematuria and proteinuria is present, with or without nephrotic syndrome, hypertension, and elevated serum creatinine.
Lupus nephritis stage IV (diffuse proliferative) is both the most severe and the most common type. In it,> 50% of glomeruli are involved which can be segmental or global and active or chronic, with or Extracapillary endocapillary proliferative lesions. Electron microscope, the subendothelial deposits are noted, and some mesangial changes may be present. Immunofluorescence reveals called "Full House" spot, stain positively for IgG, IgA, IgM, C3 and C1q. "Clinically, hematuria and proteinuria is present, often with nephrotic syndrome, hypertension, hypocomplementaemia, high anti-DNA and raising titles serum creatinine.
diagnosis
Class I is minimal mesangial glomerulonephritis which is histologically normal on light microscopy but with mesangial deposits on electron microscopy. It constitutes about 5% of cases of lupus nephritis. Renal failure is very rare in this form.
Class II is based on a finding of mesangial proliferative lupus nephritis. This form usually responds completely to treatment with corticosteroids. It represents about 20% of cases. Renal failure is rare in this form.
Class III is focal proliferative nephritis, and often successfully respond to treatment with high doses of corticosteroids. It represents about 25% of cases. Renal failure is rare in this form.
Class IV diffuse proliferative nephritis. This form is mainly treated with corticosteroids and immunosuppressant drugs. It represents about 40% of cases. Kidney failure is common in that form.
Class V is membranous nephritis and is characterized by extreme edema and protein loss. It represents about 10% of cases. Renal failure is rare in this form.
treatments
Class I is minimal mesangial glomerulonephritis which is histologically normal on light microscopy but with mesangial deposits on electron microscopy. It constitutes about 5% of cases of lupus nephritis. Renal failure is very rare in this form.
Class II is based on a finding of mesangial proliferative lupus nephritis. This form usually responds completely to treatment with corticosteroids. It represents about 20% of cases. Renal failure is rare in this form.
Class III is focal proliferative nephritis, and often successfully respond to treatment with high doses of corticosteroids. It represents about 25% of cases. Renal failure is rare in this form.
Class IV diffuse proliferative nephritis. This form is mainly treated with corticosteroids and immunosuppressant drugs. It represents about 40% of cases. Kidney failure is common in that form.
Class V is membranous nephritis and is characterized by extreme edema and protein loss. It represents about 10% of cases. Renal failure is rare in this form.
Characteristic treatments
Micro-Chinese Medicine Osmotherapy
immunotherapy
immunotherapy
complications
1. Cognitive Impairment
2. This section will focus on how lupus can affect your kidneys, suggestions on how to improve your kidney function and how to manage lupus nephritis.
3. "Lupus", or systemic lupus erythematosus (SLE) is a disorder that can affect various parts of the body, including the skin, joints and kidneys.

4. Sjögren and systemic lupus erythematosus: Sjögren's syndrome is characterized by inflammation of the exocrine glands, which results in a variety of symptoms, including dry eye and dry mouth, and other symptoms depending on the glands affected