Author/Authors :
Akbarian, Mahmood Department of Rheumatology - Shariati Hospital - School of Medicine - Tehran University of Medical Sciences , Soleymani, Hosein Department of Rheumatology - Shariati Hospital - School of Medicine - Tehran University of Medical Sciences , Gharibdoost, Farhad Department of Rheumatology - Shariati Hospital - School of Medicine - Tehran University of Medical Sciences , Nadji, Abdolhadi Department of Rheumatology - Shariati Hospital - School of Medicine - Tehran University of Medical Sciences , Jamshidi, Ahmadreza Department of Rheumatology - Shariati Hospital - School of Medicine - Tehran University of Medical Sciences , Shahram, Farhad Department of Rheumatology - Shariati Hospital - School of Medicine - Tehran University of Medical Sciences , Akhlaghi, Masoumeh Department of Rheumatology - Shariati Hospital - School of Medicine - Tehran University of Medical Sciences , Khosravi, Shahrzad Department of Rheumatology - Shariati Hospital - School of Medicine - Tehran University of Medical Sciences , Almasi, Simin Department of Rheumatology - Shariati Hospital - School of Medicine - Tehran University of Medical Sciences , Davatchi, Fereydoun Department of Rheumatology - Shariati Hospital - School of Medicine - Tehran University of Medical Sciences
Abstract :
Isolated hematuria and its association with proteinuria, and urinary cast and systemic lupus erythematosus
(SLE) disease activity, and decision for renal biopsy is a dilemma for physician in SLE patients.
The aim of this study was to investigate 1. whether isolated hematuria is associated with active
SLE, 2. to determine duration between hematuria and proteinuria and urinary cast, and 3. to determine
renal histological type in SLE patients with isolated hematuria. All episodes of isolated
hematuria between 1981 and 1997 were identified from Lupus Unit, Rheumatology Research Center
database. Isolated hematuria was defined as >5 RBC/hpf in the absence of urinary infection and
other renal manifestations. Relation of hematuria was assessed with proteinuria and urinary cast
and SLE disease activity. Needle renal biopsy was done in 19 SLE patents with isolated hematuria.
4.42% (31/700) of our cohort had at least one episode of isolated hematuria. Out of 31 patients in
whom the isolated hematuria was the first documented renal manifestation, 11 patients (35.48%)
developed another renal manifestation (25.8% proteinuria and 9.67% casts). 54.54% (6/11) of patients
developed proteinuria and urinary cast within 3 months. The mean time for development of a
second renal manifestation for the patients with isolated hematuria was 19.9 months. Renal needle
biopsy was performed for 19 patients (5.78% type IV, 63.15% type III and 21.50% type II). The
results of the present study indicate that isolated hematuria is not rare in SLE patients. Also, there was
no significant relationship between isolated hematuria and anti ds-DNA, C3, C4 and major organ involvement
in patients with SLE. Our study suggests that SLE patients who have isolated hematuria should undergo
renal biopsy and that isolated hematuria should be considered a manifestation of active renal SLE.
