ABSTRACT
Por medio de un estudio de casos y controles se analizaron las historias de 297 pacientes con lupus eritematoso sistemico, atendidos en la consulta externa del Servicio de Reumatologia del Hospital Universitario San Vicente de Paul, en Medellin, Colombia, entre 1970 y 1987. Se documento compromiso renal en 156 (52.5%). Hubo 94 que presntaron alteraciones en el sedimento urinario sin evidencia clinica de lesion renal. La nefropatia como primera manifestacion de la enfermedad se encontro en 14 pacientes (4.7% del grupo total); en 48 de los pacientes que tenian nefropatia (30.8%) se hallo la preoteinuria en rangos nefroticos; en 19 (6.4%) hubo insuficencia renal aguda y en 15 (5.0%) insuficiencia renal cronica. Desde el punto de vista histologico se estudiaron 79 biopsias renales; de ellas 7 (8.9%) fueron clasificadas como glomerulonefritis (GN) mesangial; 17 (21.5%) como GN proliferativa local; 38 (48.1%) como GN proliferativa difusa y 9 (11.4%) como GN membranosa. La fercuencia de las siguientes manifestaciones fue significativamente mayor en pacientes con nefropatia: livedo reticularis, vasculitis, ulceras orales, tromboflebitis, psicosis, cefalea y depresion
By means of a case-control study we analyzed the cllnlcal histories of 297 patients with systemic erythematous lupus, that were seen at the out-patient section of the Rheumatology Service, Hospital Universitario San Vicente de Paúl, in Medellín, Colombia, between 1970 and 1987. Renal involvement was documented in 156 (52.5%) cases while in 94 (31.6%) there were alterations in the urinary sediment without clinical evidence of renal lesions. Nephropathy was the first evidence of disease in 14 patients (4.70¡0 of the total group); in 48 of those with nephropathy proteinuria was in the nephrotic range; acute renal insufficiency was found in 19 patients (6.4%) while in 15 (5.0%) there was chronic renal insufficiency. Seventy nine renal biopsies were performed; their histological classification was as follows: mesangial glomerulonephritis 7 (8.9%); focal proliferative glomerulonephritis 17 (21.5%); diffuse proliferative glomerulonephritis 38 (48.1%) and membranous glomerulonephrltls 9 (11.1 %). The frequency of the following clinical manifestations was significantly higher in patients with nephropathy: Iivido reticularis, vasculitis, oral ulcers, arthritis, thrombophlebitis, psychosis, headache and depression