+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Lupus anticoagulant associated with renal thrombotic microangiopathy and pregnancy-related renal failure



Lupus anticoagulant associated with renal thrombotic microangiopathy and pregnancy-related renal failure



Quarterly Journal of Medicine 68(258): 795-815



The clinical features in 12 women with a circulating coagulation inhibitor (lupus 'anticoagulant') were studied and correlated with findings in 22 renal biopsies in these patients. Four of 12 women had serological evidence of systemic lupus. Only two of 23 pregnancies in these women were successful. Lesions in all biopsies were remarkably similar. Seven biopsies taken during or soon after pregnancy showed acute fibrinoid lesions. 'Acute' lesions consisted of fibrin thrombi in glomeruli arterioles and arteries and double contours in glomerular capillary walls. Biopsies carried out remote from pregnancy in these seven patients showed persisting double contours in glomeruli together with narrowing of arteries due to recanalizing thrombi and cellular intimal proliferation. All other biopsies showed similar lesions. The lesions were essentially the same as those of thrombotic microangiopathy and those described previously in post-partum renal failure. Renal function was severely impaired in four patients and showed moderate impairment in two patients at the time that acute thrombotic lesions were demonstrated in glomeruli. Renal function in two patients improved during plasma exchange therapy. Because all biopsies showed either acute, healing or healed, thrombotic lesions, it is proposed that these lesions are characteristic of the renal findings in patients with a lupus 'anticoagulant'. In all but two cases the acute lesions were seen during or soon after pregnancy.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 040611145

Download citation: RISBibTeXText

PMID: 3151939


Related references

Acute renal failure secondary to thrombotic microangiopathy in a patient with systemic lupus erythematosus. Medicina Clinica 89(20): 870-872, 1987

De novo thrombotic microangiopathy in renal transplant recipients: a comparison of hemolytic uremic syndrome with localized renal thrombotic microangiopathy. American Journal of Kidney Diseases 41(2): 471-479, 2003

Renal thrombotic microangiopathy and systemic lupus erythematosus Clinical correlations and long-term renal survival. Journal of the American Society of Nephrology 5(3): 347, 1994

Renal thrombotic microangiopathy in systemic lupus erythematosus: clinical correlations and long-term renal survival. Nephrology, Dialysis, Transplantation 13(2): 298-304, 1998

Pathomorphology of the kidneys in acute renal failure caused by thrombotic microangiopathy in pregnancy, during labor and in puerperas. Arkhiv Patologii 63(5): 57-60, 2002

Acute renal failure in a renal allograft: an unusual infectious cause of thrombotic microangiopathy. American Journal of Kidney Diseases 46(1): 159-162, 2005

Acute renal failure and severe hypertension in children with renal thrombotic microangiopathy. Nephron 66(3): 302-306, 1994

Reversible renal failure due to the antiphospholipid antibody syndrome, pre-eclampsia and renal thrombotic microangiopathy. Clinical Nephrology 44(4): 271-273, 1995

Acute renal failure, systemic lupus erythematosus and thrombotic microangiopathy following treatment with beta-interferon for multiple sclerosis: case report and review of the literature. Ndt Plus 2(6): 466-468, 2009

A 3-year follow-up of a patient with acute renal failure caused by thrombotic microangiopathy related to antiphospholipid syndrome: case report. Lupus 26(7): 777-782, 2017

The spectrum of renal thrombotic microangiopathy in lupus nephritis. Arthritis Research and Therapy 15(1): R12, 2013

Acute renal failure. 3. Thrombotic microangiopathy. Nihon Naika Gakkai Zasshi. Journal of the Japanese Society of Internal Medicine 82(11): 1791-1796, 1993

Acute renal failure and thrombotic microangiopathy (TM). Giornale Italiano di Nefrologia 20(3): 285-297, 2003

Renal thrombotic microangiopathy and antiphospholipid syndrome nephropathy in a patient with lupus nephritis. Nihon Jinzo Gakkai Shi 58(1): 45-54, 2016

Renal thrombotic microangiopathy in patients with systemic lupus erythematosus and the antiphospholipid syndrome. American Journal of Kidney Diseases 20(2): 150-158, 1992