بررسي اپيدميولوژيك نفريت لوپوس در 40 بيمار بستري در بيمارستان امام خميني تهران

Epidemiologic study of 40 patients with lupus nephritis in Imam Khomeini hospital, Tehran

Introduction: Systemic lupus erythematosus (SLE) is an inflammatory systemic disease that involves different organs such as heart, lungs, hematologic and musculoskletal systems, gastrointestinal tract and kidneys. Renal involvement has specific importance in disease prognosis. The present study was conducted to identify epidemiologic status, short term effects of treatment on renal involvement, levels of complement and Anti-ds DNA in patients with lupus nephritis admitted to Imam Khomein hospital, Tehran. Methods: This descriptive study was conducted on 40 patients with lupus nephritis in internal and nephrology wards of hospital. Of these patients, 37 had documented disease. All patients had renal biopsy and had received treatment according to their pathology reports. Data including age, gender, clinical manifestation and pathologic findings were recorded. Results were reported in descriptive statistics and frequency distribution tables. Results: The patients had an average age of 12-45 years with mean age of 21.5. The most frequency was in second decade of life (48.6%). 87.5 percent of patients were female and 13.5 percent were male. Malar rash (62.5%) and fever (57.7 %) were the most prevalent clinical manifestations. The most frequent pathology and sign were type IV lupus nephritis (37.8%) and hematuria (88.9%). Based on pathology, 97 percent of patients had renal involvement. Pulse therapy with corticosteroids and cyclophosphamide wase effective against preventing chronic renal failure in 50% of type IV cases. 100 percent of patients with lupus nephritis type III had bad prognosis. Conclusion: In patients with lupus nephritis. the most prevalent clinical findings were fever and malar rash of face, the most common renal involvement was hematuria and the most frequent pathology was type IV lupus nephritis. Renal involvement and prognosis is correlated with anti ds DNA titer. Types III and IV of lupus nephritis have indication for glucocorticoids and cyclophosphamide pulse therapy which can be preventive for chronic renal failure in 50% of cases.