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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 12, Issue 2, September 2014 pp 228-232
Role of Renal Biopsy in Systemic Lupus Erythematosis (SLE)
Nisha J Marla1*, Ramesh Naik2, Hilda Fernandes3, Jayaprakash C S4, Kirana Pailoor5
1,5Associate Professor, 2,3,4Professor, Department of Pathology, Father Muller Medical College, Mangalore, Karnataka, INDIA.
Aims and Objectives: 1)To evaluate histopathological findings in Lupus Nephritis and to classify it according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS 2003) classification system forLupus Nephritis. 2) To correlate the histological findings with the disease process. Materials and Methods: Renal biopsy performed at a tertiary care centre and Hospital in South India, for duration of 2 years was collected along with relevant clinical data. Ultrasound guided renal biopsy was performed and tissue were processed routinely and the slides were stained with Hematoxylin and Eosin. Special stains that is per iodic acid Schiff (PAS) and Methanamine silver (PASM) were performed for all cases. All the cases were correlated with Immunofluroscence (IF) study. 30 Renal biopsies were performed, 21 cases were of Primary Glomerulonephritis and 9 cases were Secondary Glomerulonephritis out of which 6 were cases of Systemic Lupus Erythematosus. Renal Biopsy of all the cases of SLE was classified according to ISN/RPS classification system. Results: Out of 30 cases (n=30), Primary glomerulonephritis (GN) accounted for 70% and secondary GN accounted for 30%. Among secondary glomerulonephritis predominant lesion were systemic lupus nephritis (66.7%) followed by diabetes mellitus (22.2%) and Amyloidosis (11.1%). In secondary GN the predominant lesion was Systemic Lupus Nephritis, Out of 6 (100%) cases of Lupus Nephritis, 4 (66.7%) cases were class IV, 1(16.7%) case was class II and 1(16.7%) case was class V. Conclusion: Management goals in patients with Lupus Nephritis include early diagnosis and appropriate therapy whilst preserving overall Kidney function without undue side effects and prevent irreversible damage.ISN/RPS 2003 classification tends to correlate with clinical syndrome and provide valuable information regarding prognosis and guideline for treatment. ISN/RPS classification system also intends to facilitate a higher degree of reproducibility, resulting in a better patient care. A renal biopsy examined by routine light microscopy, Immunofluroscence and electron microscopy contributes toward diagnosis, prognostic information, and appropriate management.