A prospective observational study on the clinical profile and outcomes of lupus nephritis in patients of systemic lupus erythematosus

Background &Objective: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, with a wide range of clinical presentations resulting from its effect on multiple organ systems. This research was conductedto elucidate clinical profile and the outcomes of lupus nephritis (LN) in patients of SLE.
Methods: This prospective observational study of forty patients was conducted in Jawaharlal Nehru Hospital and Research Centre, Bhilai, Chhattisgarh, India in 2011-12. Patients follow-up was done on quarterly basis during the period of one year. The clinical manifestations, laboratory parameters and other imaging findings were analyzed.
Results: Out of 40 patients studied, 37 were females and 3 males with sex ratio 13:1. The mean age at presentation of lupus nephritis was 22.67 ± 3.51 years for male and 29.89 ± 8.40 years for female. Most common symptoms were myalgia (80%), arthralgia (80.30%), weight loss (75%) and oral ulcer (63%). 50% of patients had class IV LN with increased Erythrocyte Sedimentation Rate (ESR)(p > 0.05) followed by significant decrease in ESR, serum creatinine, 24 hours urinary protein level (p <0.05) and increased in the level of C3 and C4 post-treatment. Two patients (5%) in the study died within 6 month of diagnosis and belonged to class IV LN.
Interpretation & Conclusion: Most of LN are often asymptomatic and can be diagnosed by simple laboratory investigation and urinary examination. Immunosupressive and cytotoxic drugs have major role in treating serious form of disease and decreasing morbidity and mortality. At the end of 6 month, complete response was found in 16.66%with CYC and at 12 months 43.75%. The complications during follow-up period were gastrointestinal side effects, IGT, osteoporosis and infections.