Author/Editor     Luzar, Boštjan; Koselj, Mira; Kaplan-Pavlovčič, Staša; Ferluga, Dušan
Title     Renal lipid deposits and progression of lupus nephritis
Type     članek
Source     In: Vizjak A, Rozman B, Ferluga D, editors. Autoimmune systemic diseases. Proceedings of the 30th memorial meeting for professor Janez Plečnik; 1999 Dec 2-3; Ljubljana. Ljubljana: Faculty of medicine, Institute of pathology,
Publication year     1999
Volume     str. 99-104
Language     eng
Abstract     Systemic lupus erythematosus is an autoimmune connective tissue disease, marked by immune complex mediated lesions of blood vessels in various organs, especially kidneys. Non-immunological factors, such as nephrotic syndrome with severe proteinuria and plasma (ipid abnormalities, so as arterial hypertension, significantly contribute to the progression of renal disease. In the present article we demonstrate the role of lipids in the progresion of glomerular, vascular and tubulo-interstitial lesions in two patients with lupus nephritis, associated with a pronounced hyper and dyslipidemia. Beside immunological factors, hyperperfusion and hyperfiltration injury in the residual glomenrli resulted in profound glomerutosclerosis. Lipid droplets, associated with smalt cleft-like spaces were found in the cytoplasm of tubular epithetial celts. Needle shaped crystals, impacted in tubular lumina were seen rupturing and penetrating the plasma membrane of epithelial cells, punctuating tubular basement membrane and lodging eventually in the tubumr intetstitial comparanent. Once in interstitium, cleft-like crystals were surrounded by mononuclear cell in and foem celIs, which were in addition found dispersed throughout thc intetstitium. Diffuse and extremely pronounoed lipohyalinosis, associated with sclerosis of small arteries and arterioles, together with fibroelastic hyperplasia of small to medium sized interlobular arteries and focal calcinated atherosclerosis of intrarenal extraglomerular small arteries, was unusual observation in one case. The results of our study suggest that all parts of nephron may be involved in the pathogenetic process causally related and influenced by hyper/dyslipidemia. (Abstract truncated at 2000 characters).
Descriptors     LUPUS NEPHRITIS
HYPERLIPIDEMIA
KIDNEY DISEASES
NEPHRONS
FLUORESCENT ANTIBODY TECHNIQUE, DIRECT
MICROSCOPY, ELECTRON
VASCULAR DISEASES
SLOVENIA
LIPIDS
NEPHROTIC SYNDROME
ENDOTHELIUM, VASCULAR