All of the following factors are associated x. ith adverse prognosis and high risk of Renal progression in Lupus Nephritis, Except:
Answer is D (Anti - LA (SSB)): Presence of Anti - LA (SSB) in SLE suggests concomitant Sjogren's syndrome. In SLE, patients with concomitant Sjogren's syndrome have a lower frequency of glomerulonephritis and a relatively good prognosis - Samter's Immunologic Diseases 6th/497 Factors associated with Adevrse Prognosis and High Risk of Renal Progression in Lupus Nephritis Demographic Black race Hispanic ethnicity Male gender Extremes of age at onset of SLE Limited access to health care Clinical Hypeension Severe extrarenal (especially neuropsychiatric) lupus activity Failure to achieve remission or marked delay to renal remission Pregnancy Laboratory Nephritic urinary sediment Azotemia Anemia Thrombocvtopanea Thrombotic microangiographv (with or without anti-phospholipid antibodies) Hypocomplementemia (especially falling levels) High anti- DNA (especially rising titres) Persistent severe nephritic syndrome (aherosclerotic and thrombotic diathesis) Renal pathology Contracted kidney size Proliferative glomerulonephritis (WHO class III, IV) Mixed membranous (V) and proliferative (III-IV) glomerulonephritis Cellular crescents (>25% of glomeruli) Fibrinoid necrosis (>25% of glomeruh) Very high activity index Moderate-to-high chronicity index Combinations of active (cellular crescents) and chronic, features (interstitial fibrosis) Extensive subendothelial deposits Note: The presence of Anti-RO or Anti-La antibodies in a pregnant woman is associated with a chance of 'neonatal lupus' developing in the infant (1-5%) This may present in the fetus as a congenital hea block or neonatal lupus rash.
High levels of Anti-ds DNA
Persistant proteinuria (Nephrotic range> 3gm/day)
Hypocomplementenemia
Anti - LA (SSB)