Lupic nephropathy: a case control study in Medellín, Colombia

Abstract

By means of a case-control study we analyzed the cllnlcal histories of 297 patients with systemic erythematous lupus, that were seen at the out-patient section of the Rheumatology Service, Hospital Universitario San Vicente de Paúl, in Medellín, Colombia, between 1970 and 1987. Renal involvement was documented in 156 (52.5%) cases while in 94 (31.6%) there were alterations in the urinary sediment without clinical evidence of renal lesions. Nephropathy was the first evidence of disease in 14 patients (4.70¡0 of the total group); in 48 of those with nephropathy proteinuria was in the nephrotic range; acute renal insufficiency was found in 19 patients (6.4%) while in 15 (5.0%) there was chronic renal insufficiency. Seventy nine renal biopsies were performed; their histological classification was as follows: mesangial glomerulonephritis 7 (8.9%); focal proliferative glomerulonephritis 17 (21.5%); diffuse proliferative glomerulonephritis 38 (48.1%) and membranous glomerulonephrltls 9 (11.1 %). The frequency of the following clinical manifestations was significantly higher in patients with nephropathy: Iivido reticularis, vasculitis, oral ulcers, arthritis, thrombophlebitis, psychosis, headache and depression.