GN Associated with SLE Flashcards Preview

Nelson - Nephrology > GN Associated with SLE > Flashcards

Flashcards in GN Associated with SLE Deck (31):
1

Most important cause of morbidity and mortality in SLE

Glomerulonephritis

2

Renal disease in childhood SLE is present in up to ___% of patients

80

3

T/F Renal disease in childhood SLE is more active in children than in adults

T

4

Pathogenesis of nephritis in SLE

Binding of autoantibodies to glomerular components rather than passive trapping of immune complexes

5

Deficiency of this complement component is the strongest single genetic risk for SLE

C1q

6

Gold standard for establishing the diagnosis of SLE nephritis

Kidney biopsy

7

WHO Class: No histologic abnormalities on LM; mesangial deposits on IF and EM

I, Minimal mesangial lupus nephritis

8

WHO Class: Both mesangial hypercellularity and increased matrix along with mesangial deposits containing Ig and complement

II, Mesangial proliferative

9

WHO Class: Mesangial ang endocapillary lesions involving less than 50% glomeruli

III

10

WHO Class: Mesangial ang endocapillary lesions involving more than or equal to 50% glomeruli

IV

11

WHO Class: Resembles idiopathic membranous nephropathy with subepithelial immune deposits

V, Membranous lupus nephritis

12

T/F Ethnicity and socioeconomic factors strongly predict development of lupus nephritis in children

F

13

Patients with class V nephritis commonly present with nephritic vs nephrotic syndrome

Nephrotic syndrome

14

T/F In patients with active disease (SLE), C3 and C4 levels are depressed

T

15

T/F Renal biopsy should be performed in all patients with SLE

T, since there is a lack of a clear correlation between the clinical manifestations and the severity of the renal involvement

16

Goals of immunosuppresive therapy in lupus nephritis

1) Clinical remission 2) Serologic remission

17

SLE: Clinical remission is defined as

Normalization of renal function and proteinuria

18

SLE: Serologic remission is defined as

Normalization of anti-DNA Ab, C3 and C4 levels

19

SLE: Prednisone is initiated at a dose of

1-2 mkday

20

SLE: Prednisone tapering

Over 4-6 mos begininning 4-6 weeks after receiving serologic remission

21

SLE: For patients with more severe forms of nephritis (Class III-IV) induction therapy begins with

6 consecutive monthly Cyclo at 500-1000 mg/m2; followed by infusions every 3 months for 18 months

22

SLE: Renal survival is defined as

CKD without the need for ESRD therapy

23

WHO class of SLE nephritis that exhibits the highest risk for progression to ESRD

Class IV

24

Risks of malignancy or infertility may be increased in those receiving a cumulative dose of ___ of Cyclo or other immunosuppresive therapies

>20g

25

Characterized by mesangial and endocapillary lesions

Class III and IV

26

T/F WHO Class IV Lupus nephritis is associated with poorer outcomes but can be successfully treated with aggressive immunosuppresive therapy

T

27

Clinical findings in milder forms of lupus nephritis (Class I, II, and some III)

1) Hematuria 2) NORMAL RENAL FUNCTION 3) Proteinuria <1g/24h

28

Clinical findings in more severe forms of lupus nephritis (Class III and IV)

1) Hematuria 2) Proteinuria 3) Reduced renal function 4) Nephrotic syndrome 5) Acute renal failure

29

Therapy is initiated in all patients with what drug

Prednisone

30

May be used as a steroid-sparing agent in patients with WHO class I or II lupus nephritis

Azathrioprine

31

Renal survival without need for dialysis is seen in 80% of patients ___ years after diagnosis of SLE nephritis

10