MO119: Lupus Nephritis in Males: About 34 Cases

Abstract

Abstract BACKGROUND AND AIMS Lupus nephritis (LN) is one of the most serious manifestations of systemic lupus erythematosus (SLE), affecting mainly young women, but can also affect men. It refers to the development of intrarenal tissue inflammation responsible for various damage at this level: glomerular, vascular and/or tubulointerstitial lesions. This complication, which can be inaugural, occurs in the majority of cases early in the history of the disease, and constitutes a major evolutionary turning point, which can lead to end-stage chronic renal failure in 5–10% of cases. The aim of our study was to analyse the different characteristics of NL in humans, since the latter is little studied due to the rarity of cases. METHOD We conducted a descriptive retrospective study at the nephrology departments of the Ibn Rochd University Hospital in Casablanca, from January 2011 to August 2021 (i.e. 10 years) on LN. All male patients (34 cases) who developed LN confirmed on renal biopsy. RESULTS The average age of the patients was 29.41 years with extremes ranging from 15 to 56 years among them five black patients. The circumstance of discovery of LN was edematous syndrome in 46.87%, nephrotic syndrome 37.5% and renal failure in 15.62% of cases. The renal manifestations were made of arterial hypertension in 21.87% of cases, and haematuria in 15.62% of cases. The extrarenal manifestations were articular in 37.5% of cases, cutaneous in 56.25% of cases and 40.62% of cases had general signs. Biologically, on the blood count, haemolytic anaemia was observed in 87.5% of cases, lymphopenia in 31.25% of cases and thrombocytopaenia in 40.62%, while AANs were positive in 96.87% and anti-DNA antibody were positive in 93.75%. Hypocomplementemia was objectified in 84.37%. Histologically: according to the World Health Organization classification of LN, we have reported: LN class I in a single patient, i.e. 3.12%, and LN class III in 12.5% of cases, LN class IV in 53.12% and LN class V in 31.25%, while the combination of class V and III was seen in one patient and the combination of class IV and V in three cases. Concerning the evolution 34.37% progressed well with complete remission, 31.2% of patients relapsed, while three patients progressed to end-stage kidney disease (ESKD) and all of three from black. The evolution was also marked by death in eight patients; among them four were black. CONCLUSION Lupus disease is more aggressive in men and is characterized by a higher rate of complications, including kidney damage. In our study, we were able to deduce that LN in the black race has a bad prognosis.