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phosphorus 4&#46;2mg&#47;dl and total proteins 9g&#47;dl&#46; Creatinine clearance rate &#40;Cockcroft-Gault formula&#41;&#58; 17&#46;73ml&#47;min&#46; Immunoproteins and complements were normal&#46; Kappa chains 774mg&#47;dl&#44; Lambda chains 392mg&#47;dl&#46; In the proteinogram&#44; we observed a wide-base peak in the Gamma region with increased IgG &#40;193&#37;&#41; and light Kappa &#40;191&#37;&#41; and Lambda chains &#40;180&#37;&#41;&#46; K&#47;L index &#61; 1&#46;97&#46; Light chains in urine&#58; Kappa chains 13&#46;7mg&#47;dl &#40;0-0&#46;7&#41;&#59; Lambda chains 6&#46;880 &#40;0-0&#46;39&#41;&#46; A bone marrow aspiration and biopsy was performed&#44; with a normal result&#46; TSH&#58; 4&#46;85&#956;UI&#47;ml&#44; free T4 1&#46;03ng&#47;fl&#59; anti-TPO antibodies 22&#46;5UI&#47;ml&#59; antithyroglobulin antibodies 115&#46;3UI&#47;ml&#46; PTH&#58; 110pg&#47;ml&#46; Urine &#40;test strip&#41;&#58; Proteins 25mg&#47;l&#59; sediment&#58; abundant leukocytes&#46; Tumour markers&#58; normal&#46; Viral serology&#58; negative&#46; Autoantibodies&#58; ANA&#43;&#44; anti-DNApositive&#46;</p><p class="elsevierStylePara">A percutaneous renal biopsy was performed &#40;with 18 verifiable glomerules&#41;&#58; No significant glomerular alterations&#46; The tubules presented dilated lumens occupied by granular cylinders containing cellular detritus&#46; Tubular atrophy foci and hyaline cylinders were present &#40;figure 1&#41;&#46; In the interstitium and vessels&#44; abundant lymphocyte infiltrates&#44; mostly from plasma cells that broaden the interstitium&#44; provoke the collapse and disappearance of tubules as well as the erosion and epithelial infiltration of basement membranes &#40;figure 2&#41;&#46; With immunofluorescence&#44; we observed granular deposits in the arterial walls of complement C&#191;3 &#40;&#43;&#43;&#41; and tubular cylinders of IgA &#40;&#43;&#43;&#41;&#46; Using immunohistochemical techniques&#44; we found linear deposits of light kappa chains on tubular basement membranes&#46; Anatomical-pathological diagnosis was inflammatory tubulo-interstitial nephritis&#46; This morphological profile appears in 10&#37; of patients who suffer plasma cell dyscrasias&#44; most frequently in myeloma with a predominance of light K chains&#46;</p><p class="elsevierStylePara">In most cases of SLE&#44; the glomerular condition is the main histological lesion&#46; An isolated condition affecting the tubule and interstitium is rare&#46;</p><p class="elsevierStylePara">We ruled out other causes of tubulointerstitial nephritis&#44; such as drugs or toxins&#46; The intense presence of tubulointerstitial damage in absence of significant glomerular damage supports the theory that immune complexes are bound to one or more tubulo-interstitial autoantigens that are not expressed in the glomerulus&#46; The underlying mechanism represents in situ formation of immune complexes as a result of circulating autoantibodies binding to antigens&#46;<span class="elsevierStyleSup">3</span> Although the exact mechanism is unknown&#44; it is possible that its virulence depends on the structural characteristics of the antigenantibody union region&#44; the isotope&#44; and the isoelectric charge&#46;<span class="elsevierStyleSup">3</span> A recent study describes how the union of T CD4&#43; cells with antigens in the glomerular basement membrane can begin the&#160; glomerular damage that will trigger glomerulonephritis&#46; It is possible that a similar mechanism might participate in the pathogenesis of tubulo-interstitial nephritis in such a way that cell immunity damages tubular antigens&#59; this would trigger an interstitial condition&#44; as in other interstitial nephropathies&#46;<span class="elsevierStyleSup">4</span></p><p class="elsevierStylePara">The treatment of tubulo-interstitial nephritis in SLE is not wellestablished&#44; but it seems not to require immunosuppressant therapy&#44; and it might respond to low doses of oral steroids&#46;<span class="elsevierStyleSup">5</span></p><p class="elsevierStylePara"><a href="grande&#47;43518078&#95;f1&#95;pag502&#46;jpg" class="elsevierStyleCrossRefs"><img src="43518078_f1_pag502.jpg"></img></a></p><p class="elsevierStylePara">Figure 1&#46; 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                  "referenciaCompleta" => "Austin HA. Clinical evaluation and monitoring of lupus kidney disease. Lupus 1998;7:618-21. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9884099" target="_blank">[Pubmed]</a>"
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                  "referenciaCompleta" => "Singh AK, Ucci A, Madias NE. Predominant tubulointerstitial lupus nephritis. Am J Kidney Dis 1996;27:273-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8659506" target="_blank">[Pubmed]</a>"
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                  "referenciaCompleta" => "Weening JJ, D¿Agati VD, Schawrtz MM, Seshan SV, Alpers CE, Appel GB, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney Int 2004;65(2):521-30. <a href="http://www.ncbi.nlm.nih.gov/pubmed/14717922" target="_blank">[Pubmed]</a>"
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Isolated tubulointerstitial nephritis in a patient with systemic lupus erythematosus
Nefritis túbulointersticial aislada en paciente con lupus eritematoso sistémico
María Jesús Moyano Francoa, J.. Amor Sáncheza, R.. Ortega Ruanoa, JR.. Armas Padrónb
a Servicio de Nefrología, Hospital Universitario Virgen Macarena, Sevilla, Sevilla, España,
b Departamento de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, Sevilla, España,
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phosphorus 4&#46;2mg&#47;dl and total proteins 9g&#47;dl&#46; Creatinine clearance rate &#40;Cockcroft-Gault formula&#41;&#58; 17&#46;73ml&#47;min&#46; Immunoproteins and complements were normal&#46; Kappa chains 774mg&#47;dl&#44; Lambda chains 392mg&#47;dl&#46; In the proteinogram&#44; we observed a wide-base peak in the Gamma region with increased IgG &#40;193&#37;&#41; and light Kappa &#40;191&#37;&#41; and Lambda chains &#40;180&#37;&#41;&#46; K&#47;L index &#61; 1&#46;97&#46; Light chains in urine&#58; Kappa chains 13&#46;7mg&#47;dl &#40;0-0&#46;7&#41;&#59; Lambda chains 6&#46;880 &#40;0-0&#46;39&#41;&#46; A bone marrow aspiration and biopsy was performed&#44; with a normal result&#46; TSH&#58; 4&#46;85&#956;UI&#47;ml&#44; free T4 1&#46;03ng&#47;fl&#59; anti-TPO antibodies 22&#46;5UI&#47;ml&#59; antithyroglobulin antibodies 115&#46;3UI&#47;ml&#46; PTH&#58; 110pg&#47;ml&#46; Urine &#40;test strip&#41;&#58; Proteins 25mg&#47;l&#59; sediment&#58; abundant leukocytes&#46; Tumour markers&#58; normal&#46; Viral serology&#58; negative&#46; Autoantibodies&#58; ANA&#43;&#44; anti-DNApositive&#46;</p><p class="elsevierStylePara">A percutaneous renal biopsy was performed &#40;with 18 verifiable glomerules&#41;&#58; No significant glomerular alterations&#46; The tubules presented dilated lumens occupied by granular cylinders containing cellular detritus&#46; Tubular atrophy foci and hyaline cylinders were present &#40;figure 1&#41;&#46; In the interstitium and vessels&#44; abundant lymphocyte infiltrates&#44; mostly from plasma cells that broaden the interstitium&#44; provoke the collapse and disappearance of tubules as well as the erosion and epithelial infiltration of basement membranes &#40;figure 2&#41;&#46; With immunofluorescence&#44; we observed granular deposits in the arterial walls of complement C&#191;3 &#40;&#43;&#43;&#41; and tubular cylinders of IgA &#40;&#43;&#43;&#41;&#46; Using immunohistochemical techniques&#44; we found linear deposits of light kappa chains on tubular basement membranes&#46; Anatomical-pathological diagnosis was inflammatory tubulo-interstitial nephritis&#46; This morphological profile appears in 10&#37; of patients who suffer plasma cell dyscrasias&#44; most frequently in myeloma with a predominance of light K chains&#46;</p><p class="elsevierStylePara">In most cases of SLE&#44; the glomerular condition is the main histological lesion&#46; An isolated condition affecting the tubule and interstitium is rare&#46;</p><p class="elsevierStylePara">We ruled out other causes of tubulointerstitial nephritis&#44; such as drugs or toxins&#46; The intense presence of tubulointerstitial damage in absence of significant glomerular damage supports the theory that immune complexes are bound to one or more tubulo-interstitial autoantigens that are not expressed in the glomerulus&#46; The underlying mechanism represents in situ formation of immune complexes as a result of circulating autoantibodies binding to antigens&#46;<span class="elsevierStyleSup">3</span> Although the exact mechanism is unknown&#44; it is possible that its virulence depends on the structural characteristics of the antigenantibody union region&#44; the isotope&#44; and the isoelectric charge&#46;<span class="elsevierStyleSup">3</span> A recent study describes how the union of T CD4&#43; cells with antigens in the glomerular basement membrane can begin the&#160; glomerular damage that will trigger glomerulonephritis&#46; It is possible that a similar mechanism might participate in the pathogenesis of tubulo-interstitial nephritis in such a way that cell immunity damages tubular antigens&#59; this would trigger an interstitial condition&#44; as in other interstitial nephropathies&#46;<span class="elsevierStyleSup">4</span></p><p class="elsevierStylePara">The treatment of tubulo-interstitial nephritis in SLE is not wellestablished&#44; but it seems not to require immunosuppressant therapy&#44; and it might respond to low doses of oral steroids&#46;<span class="elsevierStyleSup">5</span></p><p class="elsevierStylePara"><a href="grande&#47;43518078&#95;f1&#95;pag502&#46;jpg" class="elsevierStyleCrossRefs"><img src="43518078_f1_pag502.jpg"></img></a></p><p class="elsevierStylePara">Figure 1&#46; 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Idiomas
Nefrología (English Edition)