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Arthritis Research and Therapy

, 14:R126

First Online: 28 May 2012Received: 17 October 2011Revised: 11 May 2012Accepted: 28 May 2012


IntroductionMicrothrombosis is often observed in lupus nephritis LN lesions, but its clinical significance is unknown. We evaluated the clinicopathologic correlations of renal microthrombosis and inflammatory markers in LN.

MethodsKidney biopsies from 58 patients with systemic lupus erythematosus SLE proliferative nephritis were analyzed with immunohistochemistry IHC for intravascular platelet aggregates CD61, macrophagic infiltration CD68, and activated complement deposition C4d. Clinical data at the time of kidney biopsy and follow-up were analyzed with regard to pathologic IHC data.

ResultsMicrothrombosis was present in 52% of the tissues. It was significantly more prevalent in patients with antiphospholipid antibodies aPLs 62% versus 42%. The presence of microthrombosis significantly correlated with higher macrophagic infiltration. Macrophagic infiltration but not microthrombosis was significantly correlated with C4d deposition. Only macrophagic infiltration showed a correlation with SLE and renal activity proteinuria and active sediment, whereas neither the presence of CD61 microthrombi nor the extent of C4d deposition correlated with LN severity or outcome.

ConclusionsMicrothrombosis is associated with higher macrophagic infiltration in LN but does not seem to increase independently the severity of renal damage. Macrophagic infiltration was the best marker of SLE and renal activity in this LN series.

AbbreviationsaCLanticardiolipin antibodies

aPLsantiphospholipid antibodies

APSantiphospholipid syndrome

ELISAenzyme-linked immunosorbent assay

HBPhigh blood pressure


ISN-RPSinternational society of nephrology-renal pathology society

LAlupus anticoagulant

LNlupus nephritis

MCP-1monocyte chemoattractant protein-1

NIHnational institute of health

ORodds ratio

PASphosphotungstic acid-hematoxylin

SLEsystemic lupus erythematosus

TGF-beta 1transforming growth factor-beta 1

TMAthombotic microangiopathy

SLEDAIsystemic lupus erythematosus disease activity index.

Electronic supplementary materialThe online version of this article doi:10.1186-ar3856 contains supplementary material, which is available to authorized users.

José L Pablos and María Galindo contributed equally to this work.

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Autor: Elena Gonzalo - Oscar Toldos - María P Martínez-Vidal - María C Ordoñez - Begoña Santiago - Antonio Fernández-Nebro


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