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