Öz
Amaç:
Böbrek biyopsisi, nadiren de olsa sistemik lupus eritematozus (SLE) hastalarında lupus nefrit (LN) dışı nedenleri gösterebilir. Bu çalışmada, SLE hastalarında lupus dışı nefrit nedenlerinin ortaya çıkarılması ve LN ile LN dışı renal hastalığın klinik ve laboratuvar özelliklerinin karşılaştırılması amaçlandı.
Yöntem:
2014-2020 yılları arasında Hacettepe Üniversitesi Tıp Fakültesi Hastaneleri’nde takip edilen ve böbrek biyopsisi yapılan SLE’li hastalar çalışmaya alındı. Yüz otuz dört hastanın böbrek biyopsisi retrospektif olarak değerlendirildi ve hastalar LN ve LN dışı renal hastalık olarak gruplandırıldı. Hastaların klinik özellikleri, böbrek biyopsisi sırasındaki laboratuvar değerleri ve renal son durumları hastane tıbbi kayıtlarından elde edildi.
Bulgular:
Yüz otuz dört (107 kadın, 27 erkek) hastanın 116’sı (%86,6) LN grubunda, 18’i (%13,4) LN olmayan gruptaydı. LN olmayan grupta en sık tanı fokal segmental glomerüloskleroz (n=6) idi. LN hastalarının medyan (çeyrekler açıklığı) biyopsi yaşı daha genç [21 (17,7) vs. 36,5 (17), p<0,001] olup SLE tanısında 1/320’nin üzerinde yüksek titre antinükleer antikor pozitifliği bu grupta daha sıktı (%50,9 vs. %22,2, p=0,02). Böbrek dışı SLE tutulumu her iki grupta da benzerdi. Renal biyopsi sırasında LN hastalarında anti-dsDNA pozitifliği, düşük C3-4 ve aktif idrar sedimenti varlığı anlamlı olarak yüksek iken serum kreatinin, albümin ve proteinüri gruplar arasında farklı değildi. Ayrıca medyan renal SLEDAI skoru LN hastalarında daha yüksekti.
Sonuç:
Anti-dsDNA pozitifliği, düşük C3-C4, aktif idrar sedimenti ve yüksek renal SLEDAI skorları, SLE hastalarında böbrek hastalığı ile ilgili bize bazı ipuçları verebilir. Ancak bu serolojik anormalliklerin lupus dışı böbrek hastalığında da ortaya çıkabileceği unutulmamalıdır.
Anahtar Kelimeler: Sistemik lupus eritematosuz, renal biyopsi, lupus dışı nefritler, lupus nefriti
Kaynakça
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