Silent Renal Involvement in Systemic Lupus Erythematosus

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Abstract
20 patients with active SLE without clinical evidence of renal involvement underwent percutaneous renal biopsy. 12 had varying proliferative changes on light microscopy. Of 19 ultrastructural examinations performed only 3 had no electron-dense deposits. Serum C3 and C4 levels were 63 ± 8 and 8 ± 2 mg% in patients with subendothelial deposits, compared to 142 ± 27 and 27 ± 6 mg%, respectively, in patients without deposits (p < 0.01). All patients with diffuse proliferative changes had subendothelial deposits; however, one with normal light microscopy and another with focal proliferation also had them. It is concluded that no variant of lupus nephropathy can be excluded on clinical grounds alone.

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