Sjogrens
All comers..
Indian Cohort of
174
- Renal Involvement: 50% invovlment ( screened
174)
- Tubular Lesions: 29/174 had RTA. Younger. Periodic
paralysis.
- Bx: few bx - , TIN 9/17, IGA 3/17.
French Cohort of 95 Biopsy
proven Renal involvment
- Renal Involvement: 97.9% had tubulointerstitial
nephritis (TIN), with plasma cell infiltrates in 75%.
- Glomerular Lesions: Found in 23.2% of patients,
often associated with cryoglobulinemia.
- Prognosis: Anti-SSA/SSB antibodies were linked to
worse outcomes.
- Treatment: Corticosteroids improved kidney
function, though no added benefit was seen with immunosuppressive agents
like rituximab.
- Outcome: Despite fibrosis, significant improvement
in eGFR was observed
Mayo biopsed
24/7276 patients over 24 years. 71% TIN, 2 cryos, 2 FSGS. 83% pred, 17
ritux. Generally improved and didnt progress regardless of Rx.
RTA
Chinese Cohort of
257 pSS RTA
- Age pSS patients with RTA had younger disease onset
(40 vs 46)
- Higher EULAR Sjogrens Disease activity index
disease activity
- eGFR lower, 25% CKD vs 6% compared to those without
renal involvement.
- Independent risk factors for RTA included early disease onset (
<35 years, OR 3), thyroid disorders (OR 1.4), arthritis(OR 1.5),
anti-SSB antibodies(OR 1.8), and elevated inflammatory markers, alk
phos, low alb, anaemnia (OR ~1.5)
Treatment
Steroids for TIN, CTX is an option,
particularly higher risk, high IgG levels
Systemic Sclerosis