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Keywords

SLE, Lupus nephritis, Correlation, C4d

Abstract

Aims and objectives: This study was performed to determine the association between histomorphological features, clinical and laboratory parameters in lupus nephritis and to study the significance of peritubular capillary C4d immunostaining in lupus nephritis.

Materials and methods: Retrospective study was conducted which included all newly diagnosed patients fulfilling the ARA criteria for SLE.

Results: Most of the patients belonged to class III (30.8%) and class IV (43.4%) lupus nephritis. Proteinuria was significantly higher in class V as compared with class II and III whereas no difference was noted for serum creatinine. Serum C4 was lower in class IV (p value = 0.008). Endocapillary hypercellularity and crescents were noted in 74.16% and 46.6% of biopsies. The features of activity were higher in class IV as compared to class III. Among the features of chronicity, glomerulosclerosis was higher in class IV (p value = 0.04). Granular peritubular capillary staining for C4d was seen only in 5 out of 30 biopsies (class V = 1 and class IV = 4). The maximum duration of follow up was 46 months for 79 patients of which 62 (78.5%) achieved remission. Renal survival showed significant correlation with serum creatinine at the time of presentation.

Conclusion: Class IV lupus presented with more active features and low C4 as compared to class III. The level of serum creatinine at presentation significantly determines the renal outcome. Peritubular capillary C4d staining is seen in only one-sixth of the biopsies; therefore, larger studies are needed to evaluate its significance.

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