Abstract
Background: Non-lupus full-house nephropathy is defined as “full-house” immunofluorescence pattern in patients without systemic lupus erythematosus. We compiled our adult case series with non-lupus full-house nephropathy evaluating etiology, clinical presentation and outcomes and in addition comparing them with lupus nephritis patients from our base records. Methods: We included patients with full-house immunofluorescence pattern in renal biopsies collected between January 2000 and January 2017, excluding lupus nephritis. Patients with Non-lupus full-house nephropathy that did not show any underlying disease (the idiopathic group) were compared with a group of lupus nephritis patients extracted from our database (n=20). Results: Non-lupus full-house nephropathy was identified in 20 patients (14 males) with mean age, 40.05 ± 12.37 years; mean serum creatinine, 1.63 ± 1.41 mg/dl and mean proteinuria, 6.35 ± 4.48 g/day. The most common light microscopy pattern was membranoproliferative glomerulonephritis in 9 cases (45%). During follow-up 4 patients met the criteria for systemic lupus erythematosus; 5 with others systemic diseases and 11 with idiopathic form. On last follow-up visit serum creatinine was higher in idiopathic non-lupus full-house nephropathy group compared to fullhouse lupus nephritis. Conclusion: Non-lupus full-house nephropathy is a rare condition, affecting mainly males, with the predominance of the idiopathic form and this form showing higher final creatinine levels compared to full-house lupus nephritis.
Highlights
Full-house nephropathy (FHN) is characterized by immunofluorescence pattern of concomitant deposition of immunoglobulins - IgG, IgA, and IgM - and two complement system components - C3 and C1q - in renal tissue [1]
Patients with FHN who do not meet the criteria for the diagnosis of systemic lupus erythematosus (SLE) and who test negative for anti-nuclear antibody (ANA) and serum anti-DNA antibodies are usually referred to as patients with lupus-like renal disease [2]
Patients that did not show any underlying disease were compared with a group of lupus nephritis patients extracted from our database (n= 20), matched by age and serum creatinine level on diagnosis
Summary
Full-house nephropathy (FHN) is characterized by immunofluorescence pattern of concomitant deposition of immunoglobulins - IgG, IgA, and IgM - and two complement system components - C3 and C1q - in renal tissue [1]. The main etiology of FHN is lupus nephritis, it has been described in other diseases, such as in infection associated glomerulopathies (hepatitis C virus or HIV), cryoglobulinemia, Henoch-Schönlein purpura, and in idiopathic forms [2]. Rijnink et al suggested that, those who present a full-house pattern on immunofluorescence without any associated disease should be classified as having “idiopathic non-lupus full-house nephropathy” [4]. Non-lupus full-house nephropathy is defined as “full-house” immunofluorescence pattern in patients without systemic lupus erythematosus. We compiled our adult case series with non-lupus full-house nephropathy evaluating etiology, clinical presentation and outcomes and in addition comparing them with lupus nephritis patients from our base records
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