[Arterial hypertension in lupus nephritis]. / Arterial'naia gipertoniia pri volchanochnom nefrite.

Incidence of arterial hypertension (AH), its relation with activity of lupus nephritis (LN), other factors (antiphospholipid syndrome, old age, disturbances of purin and lipid metabolism), prognostic implication of AH were studied in a trial performed from 1957 to 1996. A total of 398 patients with LN were divided into 3 groups according to immunosuppressive therapy practiced in different time periods. Overall AH incidence and that of severe AH were similar at present and in the past. AH occurred frequently in patients with rapidly progressing LN and active LN with nephrotic syndrome. In remission of nephrotic syndrome AH incidence was on the decrease. This suggests that hypertension may be a criterion of LN activity. AH was also associated with the presence of antiphospholipid syndrome and old age. AH was a separate prognostic indicator in respect to overall and renal survival. Hemodynamic mechanisms may contribute to LN progression.

[Thrombocytopenia in patients with lupus nephritis]. / Trombotsitopeniia u bol'nykh volchanochnym nefritom.

60 patients with lupus nephritis (LN) were examined for frequency of thrombocytopenia, role of IgG and IgM antibodies to cardiolipin (AC), antithrombocytic antibodies (AA) and anaerobic platelet metabolism. Thrombocytopenia occurred in 28 (46.7%) patients, it was 2 times more frequent in active LN patients with AC than in those free of AC. AA were recorded in 36.6% of patients (32.2% versus 37.5% for patients with thrombocytopenia and free of it, respectively). In active LN platelet activity and metabolism became enhanced. Genesis of thrombocytopenia in various LN forms may be induced by different mechanisms.

[The characteristics of kidney involvement in a female patient with systemic lupus erythematosus and the antiphospholipid syndrome]. / Osobennosti porazheniia pochek u bol'noi sistemnoi krasnoi volchankoi s antifosfolipidnym sindromom.

A case of rapidly progressive nephritis is reported in a female patient having systemic lupus erythematosus (SLE) with antiphospholipid syndrome. Clinical presentation of progressive lupus nephritis with intensifying renal insufficiency, arterial hypertension, hematuria, nephrotic syndrome was associated with unusual morphological manifestations of mesangiocapillary glomerulonephritis with advanced vasculitis. The authors attribute a malignant nephritis course atypical for patients with antiphospholipid syndrome to development of renal vasculitis. The discussion covers lupus genesis of vascular involvement, a probable triggering role of antibodies to phospholipids in impairment of endothelial cells.

[A histochemical evaluation of thrombocyte metabolism in systemic lupus erythematosus]. / Gistokhimicheskaia otsenka metabolizma trombotsitov pri sistemnoi krasnoi volchanke.

To determine feasibility of using quantitative histochemical assessment of platelet anaerobic metabolism in lupus nephritis (LN) prognostication and elucidation of its activity, the authors examined 23 SLE patients. 20 of them developed renal lesions. Anaerobic metabolism of platelets was measured according to lactate dehydrogenase levels. All the SLE patients had significantly higher levels of the enzyme than healthy controls showed. Maximal LDG activity was registered in rapidly progressive LN with thrombocytopenia. The findings support activation of platelet hemostatic component in SLE patients and valid utilization of a new quantitative histochemical technique for determination of intracellular metabolism enzymes content.