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Classes, activity and chronicity indices, and -smooth muscle actin expression as prognostic parameters in lupus nephritis outcome

Department of Pathology, University of São Paulo, São Paulo, Brazil

R S Costa

Department of Pathology, University of São Paulo, São Paulo, Brazil; Department of Pathology, Faculty of Medicine of Ribeirão Preto, Ribeirão Preto, SP 14049-900, Brazil,rscosta{at}fmrp.usp.br

T M Coimbra

Department of Physiology, University of São Paulo, São Paulo, Brazil

M T Pastorello

Department of Pathology, University of São Paulo, São Paulo, Brazil

E B Coelho

M Dantas

Division of Nephrology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil

M A dos Reis

Department of General Pathology, Faculty of Medicine of Triângulo Mineiro, Uberaba-MG, Brazil

Renal biopsies of 86 patients with lupus nephritis were assessed according to the WHO classification, and according to activity and chronicity indices. The aim of the present study was to correlate clinical, and histological features (WHO class, activity and chronicity indices, and a-SM actin expression)with the progression of lupus nephritis, and identify the pathologicalrole of a-SM actin in lupus nephritis. The median follow-up time was 75.5 57.3 months. Two patients were grouped as WHO class IIa lupus nephritis, eight patients as class IIb, 16 patients as class III, 25 patients as class IV, 15 patients as class V, and 19 patients as mixed pattern lupus nephritis. Sex, age, race, and the a-SM actin expression in glomeruli and tubulo-interstitialarea in WHO class III and IV showed no correlation with clinical follow-up outcome of lupus nephritis. Unfavorable clinical outcome of lupus nephritis was correlated with WHO class IV compared to the other classes, and with the chronicity index in WHO class III patients.

Key Words: lupus nephritis • activity index • chronicity index • a-SM actin • prognostic factors

Lupus, Vol. 11, No. 2, 82-87 (2002)
DOI: 10.1191/0961203302lu153oa


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