The Clinical and Pathological Findings Among Patients with Lupus Nephritis in Shiraz, Southern Iran

Systemic lupus erythematosus is a chronic, debilitating autoimmune disorder that involves multiple organ systems. Nephritis is a component of systemic lupus erythematosus that influence the long-term outcome of the patients and remains the leading cause of death in theses patients. This study was performed to evaluate the demographic, clinical, and histopathological features of Iranian patients with lupus nephritis in Shiraz, Iran. A retrospective survey was performed on 200 patients with renal involvement and SLE who referred to Rheumatology Research Center of Shiraz University of Medical Sciences since 1976. Among 35 patients (17.5%), renal biopsy was not performed and excluded from the study. Patients medical recording files were reviewed for demographic, clinical presentation of SLE, development of nephritic syndrome, renal failure, end stage renal disease (ESRD) during nephritis, the mortality rate and probable causes of death. The mean age of the patients was 23.369.2 years at the time of diagnosis of SLE. Among the 200 performed biopsies, 35 cases had failure. The remaining 165 patients had the following WHO classification: class I in one, class II in 30, class III in 33, class IV in 58, and class V in 43 patients. The most frequent clinical presentations of SLE were arthralgia, edema, and skin rash. The mean value of SLE activity index (SLEAI) was 8.9. There may be differences of clinical and histopathological manifestations of SLE and lupus nephritis considering geographical distribution of the patients.