fetching data ...

ABS0455 (2025)
IgA NEPHROPATHY IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS IgA NEPHROPATHY IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS
Keywords: Outcome measures, Comorbidities, Renal System
D. Monova1, T. Todorov2, S. Monov3
1Medical University - Sofia, Medical Institute - MI, Sofia, Bulgaria
2Medical University - Sofia, Department of Rheumatology, Sofia, Bulgaria
3Medical University - Sofia, Departmant of Rheumatology, Sofia, Bulgaria

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystemic involvement with a broad spectrum of clinical manifestation. Renal involvement in SLE is one of the most typical aspects of the disease. Renal biopsy specimens from patients with SLE rarely show changes that are pathogenetically and morphologically unrelated to SLE. The morphology and behavior of these nonlupus nephritides are not well known. IgA nephropathy (IgAN), although being the most common cause of glomerulopathy in general population, is rarely associated with SLE. Although IgAN and lupus nephritis (LN) share some common physiopathological characteristics, their laboratory and histopathologic findings and the extra-renal clinical manifestations are different and support a different pathogenesis. The distinction between IgAN and LN in SLE patients has important prognostic and therapeutic implications.


Objectives: The aim of this study is to investigate the characteristics of SLE patients diagnosed with IgA nephropathy.


Methods: A retrospective analysis was conducted on 439 SLE patients who underwent renal biopsies between 1984 and october 2024. Patients diagnosed with renal diseases other than LN were identified and were selected for studies, with a particular focus on IgA nephropathy. Baseline characteristics, laboratory findings, and renal biopsy pathologic findings were collected and statistical analyses were performed.We focus on the population of patients with lupus nephritis with obvious IgA deposits in the kidneys.


Results: Among 439 SLE patients who underwent renal biopsies, 17 were diagnosed with renal diseases other than LN. The most common non-LN pathology was IgA nephropathy – 8 patients. A comparison between patients with IgA nephropathy and class II LN (51 patients) showed no significant differences in age, sex, SLEDAI, eGFR or priteinuria and revealed similarities in clinical, immunological, biochemical and pathological characteristics, although there were differences in immunofluorescence findings. Both conditions are associated with immune complex formation and mesangial immune deposits. Immunological and biochemical similarities between SLE and IgAN demonstrate a direct link to impaired immune function in both diseases. Patients with lupus nephritis and IgAN both have circulating immune complexes and display anti-C1q antibodies, which might point to certain pathogenic similarities in these glomerular disorders. In pathologic finding, IgA nephropathy exhibited predominant IgA staining with higher intensity, while class II LN demonstrated “Full house” pattern. Long-term renal outcomes did not significantly differ between the two groups.


Conclusion: SLE patients can have renal diseases other than LN and IgA nephropathy was the most observed non-LN pathology in SLE patients. Our case highlights the importance of renal biopsy in lupus patients with urinary alterations since a correct diagnosis would permit the most appropriate treatment to be started, avoiding unnecessary immunosuppressive treatments.


REFERENCES: [1] Monova, D., S. Monov, R. Rashkov, J. Sheitanov, N. Belovezhdov. High-risk features of lupus nephritis: clinical and hystological factors in 86 patients. In: “Proceedings of the 5 -th Congress of BANTAO” (Editors: J. N. Botelis, Ch. Iatron, M. Siakotos, Ch. P. Stathakis), Greece, 2001, 65-67.

[2] Monova, D., S. Monov, T. Todorov. Clinical and Morphological Differences between class IV-S and class IV-G lupus nephritis. – ISRN Immunology, 2011; 1: 1-5.

[3] Monov, S., D. Monova, E. Peneva, R. Shumnalieva. Comparison between juvenile-, adult-, and late-onset systemic lupus erythematosus. EULAR Congress, 8-11 June 2016, London, England, SAT0017 [резюме, публикувано в Annals of the Rheumatic Diseases, 2016; 75 (2): 1078.


Acknowledgements: NIL.


Disclosure of Interests: Daniela Monova: None declared, Todor Todorov: None declared, Simeon Monov AbbVie, Pfizer.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.


DOI: annrheumdis-2025-eular.B1675
Keywords: Outcome measures, Comorbidities, Renal System
Citation: , volume 84, supplement 1, year 2025, page 2205
Session: Systemic lupus erythematosus (Publication Only)