Clinical Outcomes and Clinico-pathological Correlations in Lupus Nephritis with Kidney Biopsy showing Thrombotic Microangiopathy

Objective Renal thrombotic microangiopathy (TMA) is an uncommon pathological finding in lupus nephritis (LN), and its clinical significance remains to be defined. Methods 24 patients with lupus nephritis (LN) and renal TMA were selected from a retrospective review of 677 biopsy-proven LN patients, and compared with 48 LN Controls without TMA (in 1:2 ratio) matched according to demographics and treatments. Results Renal TMA was noted in 3.5% of kidney biopsies of LN. TMA was associated with a higher prevalence of anti-Ro (45.8% vs. 18.8%, p=0.016), higher SLEDAI scores (21.4±8.5 vs. 10.8±2.0, p Conclusion TMA in kidney biopsy was associated with more severe clinical and histological activity, and significantly inferior long-term renal outcome in LN.