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Open Access Highly Accessed Research article

The spectrum of renal thrombotic microangiopathy in lupus nephritis

Di Song1, Li-hua Wu12, Feng-mei Wang1, Xiao-wei Yang1, Di Zhu1, Min Chen1, Feng Yu1*, Gang Liu1 and Ming-hui Zhao1

Author Affiliations

1 Renal Division, Department of Medicine, Peking University, First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing 100034, PR China

2 Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia 750004, PR China

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Arthritis Research & Therapy 2013, 15:R12  doi:10.1186/ar4142


Please see the related editorial by Anders et al., http://arthritis-research.com/content/15/2/108

Published: 15 January 2013

Additional files

Additional file 1:

Figure S1. Renal TMA identified by electron microscopy. (A) Electron micrograph showed glomerular endothelial cell proliferation with narrowed capillary lumen, and widening of subendothelial space with electron dense deposits and infiltration of monocyte (EM × 5,000). (B) Higher magnification of part of Figure A, subendothelial widening with lucent area and electron dense deposits (EM × 20,000).

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Additional file 2:

Figure S2. Renal TMA identified by light microscopy and C4d staining on renal vessels. (A-C)Thrombotic microangiopathy superimposed on lupus nephritis: (A) Glomerular endocapillary hypercellularity with intraluminal thrombus (Masson's trichrome ×400). (B) Thrombosis in interlobular arteriole (Periodic Acid-Silver Methenamine and Masson's trichrome ×400) (C) The thickened arteriole with swelling of endothelial cells and intimal fibrosis (Periodic Acid-Silver Methenamine and Masson's trichrome ×400). (D) C4d is positive beneath the vascular endothelium and within the basement membrane around the medial myocytes in patient with lupus nephritis (Original magnification ×400).

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Additional file 3:

Table S.1 Multivariate survival analysis of patients' renal prognosis with lupus nephritis. Renal TMA and serum creatinine value were independent prognostic factors for renal survival.

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