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MR Vol.12 No.2 indexに戻る
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MODERN RHEUMATOLOGY
Vol.12 No.2 |
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Renal involvement in rheumatoid arthritis: analysis
of renal biopsy specimens from 100 patients |
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| H. Makino1, Y. Yoshinaga2, Y. Yamasaki1,
Y. Morita1, H. Hashimoto3, M. Yamamura1 |
(1)Department of Medicine and Clinical Science,
Okayama University Graduate School of Medicine and Dentistry, 2-5-1
Shikata-cho, Okayama 700-8558, Japan Tel. +81-86-235-7232; Fax +81-86-222-5214
e-mail: makino@med.okayama-u.ac.jp
(2)Department of Rheumatology, National Minami-Okayama Hospital, Okayama, Japan
(3)Department of Medicine, National Hospital Okayama Medical Center,
Okayama, Japan |
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| Abstract |
| Abstract We analyzed renal biopsy specimens from
100 patients to evaluate the characteristics of renal involvement
in patients with rheumatoid arthritis (RA). Membranous nephropathy
(MN) was the most common renal histological pattern (31%). Mesangial
proliferative glomerulonephritis (GN) was found in 21% of cases (IgA
nephropathy 12%, non-IgA GN 9%), minor changes in 17%, renal amyloidosis
in 11%, interstitial nephritis in 9%, sclerotic GN in 4%, and crescentic
GN in 2%. MN was relatively more frequent in men than in women, and
most developed nephrotic syndrome, while a few developed renal failure.
Disease-modifying antirheumatic drugs (DMARDs) correlated with MN
in 26 of 31 cases. Mesangial proliferative GN showed high-grade hematuria.
Amyloidosis correlated with long duration of RA; approximately half
of the cases with amyloidosis also had nephrotic syndrome, and 82%
developed renal failure. Of the 100 patients, 82% showed some tubulo-interstitial
changes, which might be related to non-steroidal anti-inflammatory
drugs. Because renal lesions in RA are very diverse, and early stage
cases of MN and amyloidosis can be detected only by histological
examinations, renal biopsy should be performed in cases with continuous
urinary abnormalities or progressive renal failure. |
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| Key words |
| Key words Disease-modifying antirheumatic
drugs (DMARDs) ・ Glomerulonephritis (GN) ・ Renal biopsy ・ Rheumatoid
arthritis (RA) |
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