Task force report on non-criteria manifestations: Nephropathy

Maria G. Tektonidou, Horacio E. Adrogué, SmitA Vaidya

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

A small-vessel vaso-occlusive nephropathy defined as antiphospholipid syndrome-associated nephropathy (APS nephropathy) has been recently recognized. APS nephropathy was first described in primary APS patients, characterized by acute thrombotic lesions in glomeruli and/or arterioles (thrombotic microangiopathy) and chronic vascular lesions, such as fibrous intimal hyperplasia of arterioles and interlobular arteries, organized thrombi with or without recanalization, and fibrous arterial and arteriolar occlusions or focal cortical atrophy. Similar lesions were further detected in systemic lupus erythematosus (SLE)-related APS and SLE/non-APS patients with positive antiphospholipid antibodies (aPLs), independently of lupus nephritis. Hypertension is the predominant clinical manifestation of APS nephropathy, followed by hematuria, proteinuria (from mild-to-nephrotic range), and renal insufficiency. Arterial thromboses (especially stroke), pulmonary embolism, livedo reticularis, anticardiolipin antibodies, and a positive lupus anticoagulant test are strongly associated with histological lesions of APS nephropathy. According to the report of a task force group on non-criteria APS manifestations held in the context of the 13th International Congress on aPL, APS nephropathy occurs almost exclusively among patients with positive aPL (with or without APS) in comparison with those without aPL and it is more frequent in APS patients (primary or SLE related) than in SLE/aPL/non-APS patients. aPLs correlate with both acute and chronic lesions of APS nephropathy. Currently, there is no consensus on the management of APS nephropathy that it may occur or improve despite full-dose anticoagulation. Multicenter studies are needed to examine the full spectrum of clinical and histological characteristics, renal outcome, and treatment approach of this nephropathy.

Original languageEnglish (US)
Title of host publicationAntiphospholipid Syndrome: Insights and Highlights from the 13Th International Congress on Antiphospholipid Antibodies
PublisherSpringer US
Pages207-221
Number of pages15
ISBN (Print)9781461431947, 9781461431930
DOIs
StatePublished - Jan 1 2012

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Antiphospholipid Syndrome
Advisory Committees
Systemic Lupus Erythematosus
Antiphospholipid Antibodies
Arterioles
Thrombosis
Livedo Reticularis
Tunica Intima
Thrombotic Microangiopathies
Lupus Coagulation Inhibitor
Anticardiolipin Antibodies
Lupus Nephritis
Hematuria
Pulmonary Embolism
Proteinuria
Multicenter Studies
Atrophy
Hyperplasia
Renal Insufficiency
Blood Vessels

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tektonidou, M. G., Adrogué, H. E., & Vaidya, S. (2012). Task force report on non-criteria manifestations: Nephropathy. In Antiphospholipid Syndrome: Insights and Highlights from the 13Th International Congress on Antiphospholipid Antibodies (pp. 207-221). Springer US. https://doi.org/10.1007/978-1-4614-3194-7_14

Task force report on non-criteria manifestations : Nephropathy. / Tektonidou, Maria G.; Adrogué, Horacio E.; Vaidya, SmitA.

Antiphospholipid Syndrome: Insights and Highlights from the 13Th International Congress on Antiphospholipid Antibodies. Springer US, 2012. p. 207-221.

Research output: Chapter in Book/Report/Conference proceedingChapter

Tektonidou, MG, Adrogué, HE & Vaidya, S 2012, Task force report on non-criteria manifestations: Nephropathy. in Antiphospholipid Syndrome: Insights and Highlights from the 13Th International Congress on Antiphospholipid Antibodies. Springer US, pp. 207-221. https://doi.org/10.1007/978-1-4614-3194-7_14
Tektonidou MG, Adrogué HE, Vaidya S. Task force report on non-criteria manifestations: Nephropathy. In Antiphospholipid Syndrome: Insights and Highlights from the 13Th International Congress on Antiphospholipid Antibodies. Springer US. 2012. p. 207-221 https://doi.org/10.1007/978-1-4614-3194-7_14
Tektonidou, Maria G. ; Adrogué, Horacio E. ; Vaidya, SmitA. / Task force report on non-criteria manifestations : Nephropathy. Antiphospholipid Syndrome: Insights and Highlights from the 13Th International Congress on Antiphospholipid Antibodies. Springer US, 2012. pp. 207-221
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