Vol.20 No.2

Original Article

Investigation of pathological and clinical features of lupus nephritis in 73 autopsied cases with systemic lupus erythematosus

Authors

Takayuki Kon1 , Ken Yamaji1 , Kaoru Sugimoto1 , Michihiro Ogasawara1 , Kazuo Kenpe1 , Hitoshi Ogasawara1 , Kwang-Seok Yang2 , Hiroshi Tsuda2 , Toshiharu Matsumoto3 , Hiroshi Hashimoto1 , Yoshinari Takasaki1

  • Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, 11th Floor, 9th Building, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8431, Japan
  • Geriatric General Medicine, Juntendo Tokyo Kotoh Geriatric Medical Center, Tokyo, Japan
  • Department of Pathology (I), Juntendo University School of Medicine, Tokyo, Japan
Received:

25 May 2009

Accepted:

22 November 2009

Published online:

29 December 2009

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Abstract

The aims of this study were to analyze the clinical and pathological features of lupus nephritis (LN) and examine the association between these features and pathological condition, treatment, and prognosis. Of the 177 systemic lupus erythematosus patients who died while receiving inpatient care at Juntendo University Hospital between 1960 and 2001, we investigated the clinical features, treatment, and pathological features of 73 of these who underwent pathological autopsy and had a clear medical history. We divided these cases into two groups, i.e., those up to 1979 (Group A) and those during and after 1980 (Group B) in order to investigate changes in tendencies by age. We also divided the cases into three groups by time interval between diagnosis and death to investigate long-term prognosis. Uremia was the direct cause of death in 38.9% of cases in Group A and only 10.8% of cases in Group B. Pathological features showed a tendency to change to a sclerotic lesion as the duration of the disorder became longer. Uremia attributable to LN was the direct cause of death in relatively fewer cases, although it is still found in the majority of LN cases and remains a problem requiring stringent management. The treatment of sclerotic lesions may be an issue that needs further attention.

Key words

Autopsy - Lupus nephritis - Pathology - Systemic lupus erythematosus