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© 1991 British Society for Rheumatology

research-article

INSIDIOUS LOSS OF RENAL FUNCTION IN PATIENTS WITH ANTICARDIOLIPIN ANTIBODIES AND ABSENCE OF OVERT NEPHRITIS

B. LEAKER*,, A. MCGREGOR{dagger}, M. GRIFFITHS{ddagger}, M. SNAITH{dagger}, G. H. NEILD* and D. ISENBERG{dagger}

*Department of Renal Medicine, Institute of Urology UCMSM, UCL, London WC2A 2EX
{dagger}Department of Rheumatology UCMSM, UCL, London WC2A 2EX
{ddagger}Department of Pathology UCMSM, UCL, London WC2A 2EX

Correspondence to: Correspondence to Dr B. Leaker, St Philip's Hospital, Sheffield Street, London WC2A 2EX

Circulating anticardiolipin antibodies are associated with recurrent thrombosis, fetal loss and thrombocytopenia. We have identified four patients with SLE or lupus-like disease who have high circulating levels of ACLA, repeated thrombosis and evidence of renal disease. Their clinical signs and symptoms of lupus activity were minimal, yet all had renal insufficiency with GFR 50 ml/min or less despite no history nor evidence of overt nephritis (proteinuriat<0.5 g/day and no haematuria). Renal biopsy specimens showed focal ischaemic lesions with no evidence of active lupus nephritis. We describe a new lesion of renal ischaemia secondary to non-inflammatory vascular pathology associated with circulating ACLA.

KEY WORDS: Anticardiolipin antibody, Lupus nephritis, SLE, Renal dysfunction


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