Abstract:

Ｏｂｊｅｃｔｉｖｅ：To assess the clinical features,pathological presentation and outcome of lupus nephritis(LN) with antineutrophil cytoplasmic antibody(ANCA) positive.
Ｍｅｔｈｏｄｏｌｏｇｙ：The pathology database at our institution was searched for cases that showed LN with ANCA positivity between January 1985 to December 2008. Their data were analyzed and compared with the control group.
Ｒｅｓｕｌｔｓ：The cohort consisted of 40 female and 9 male with an average age of 33 years at biopsy,including 38 MPOANCA,7 PR3ANCA and 4 with double positive. LN with ANCA positive exhibited higher hematuria,serum creatinine and SLEDAI score. On pathological evaluation,Class IV LN predominance was observed,accounting for 6122%. Light microscopy revealed significantly higher scores of AI and CI. Patients receiving mycophenolate mofetil (MMF) as induction therapy had higher complete remission and better renal outcome than those receiving cyclophosphamide. During followup,endstage renal disease developed in 7 (1429%) patients,all of whom were MPOANCA positive.
Ｃｏｎｃｌｕｓｉｏｎ：LN with ANCA positivity was characterized by massive hematuria,advanced renal insufficiency. Higher complete remission and better prognosis were observed when using MMF than cyclophosphamide as induction therapy.