A multicentre study of 95 biopsy-proven cases of renal disease in primary Sjögren’s syndrome - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Rheumatology Année : 2017

A multicentre study of 95 biopsy-proven cases of renal disease in primary Sjögren’s syndrome

Rafik Mesbah
  • Fonction : Auteur
Noemie Jourde-Chiche
  • Fonction : Auteur
  • PersonId : 1064169
Anne-Laure Fauchais
  • Fonction : Auteur
  • PersonId : 862208
Jean-Baptiste Fraison
  • Fonction : Auteur
  • PersonId : 973937
Eric Hachulla
  • Fonction : Auteur
  • PersonId : 948227
Pierre Ronco
  • Fonction : Auteur
  • PersonId : 842295
Philippe Vanhille
  • Fonction : Auteur
  • PersonId : 941452
Raphaele Seror
  • Fonction : Auteur
Xavier Mariette

Résumé

Objective. Renal involvement is a rare event during primary SS (pSS). We aimed to describe the clinico-biological and histopathological characteristics of pSS-related nephropathy and its response to treatment. Methods. We conducted a French nationwide, retrospective, multicentre study including pSS patients fulfilling American–European Consensus Group criteria or enlarged American–European Consensus Group criteria, and with biopsy-proven renal involvement. Results. A total of 95 patients were included (median age 49 years). An estimated glomerular filtration rate (eGFR) of <60 ml/min was found in 82/95 patients (86.3%). Renal biopsy demonstrated tubulointerstitial nephritis (TIN) in 93 patients (97.9%), and frequent (75%) plasma cell infiltrates. Glomerular lesions were found in 22 patients (23.2%), mainly related to cryoglobulin. The presence of anti-SSA (76.8%) and anti-SSB (53.8%) antibodies was particularly frequent among patients with TIN and was associated with a worse renal prognosis. Eighty-one patients (85.3%) were treated, with CSs in 80 (98.8%) and immuno-suppressive agents (mostly rituximab) in 21 cases (25.9%). Despite marked interstitial fibrosis at initial biopsy, kidney function improved significantly during the 12-month period following diagnosis (final eGFR 49.9 vs 39.8 ml/min/1.73 m2 at baseline, P < 0.001). No proven benefit of immunosuppressive agents over steroid therapy alone was found in this study. Conclusion. Renal involvement of pSS is mostly due to TIN with marked T, B and especially plasma cell infiltration. Renal dysfunction is usually isolated but can be severe. Use of CSs can improve the eGFR, but further studies are needed to define the best therapeutic strategy in this disease.
Fichier principal
Vignette du fichier
Jasiek et al, Sjogren Biopsy-proven renal disease, Rheumatology 2017.pdf (242.73 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)
Loading...

Dates et versions

hal-01791205 , version 1 (18-05-2018)

Identifiants

Citer

Magali Jasiek, Alexandre Karras, Veronique Le Guern, Evguenia Krastinova, Rafik Mesbah, et al.. A multicentre study of 95 biopsy-proven cases of renal disease in primary Sjögren’s syndrome. Rheumatology, 2017, 56 (3), pp.362-370. ⟨10.1093/rheumatology/kew376⟩. ⟨hal-01791205⟩
767 Consultations
369 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More