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kidney biopsey
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dselin68 posted:
have been tentively diagnosed by my pcp doc with lupus. my blood tests, however, are either positive or equivical, so my Ra doc, who I've only seen once, says there is nothing wrong with me. i have high ana titiers, the butterfly rash, swelling in my feet and hands, and I am in severe pain and fatigue all the time. this has gone on since 2009. For the last 6 months, i have been experiencing severe left flank pain, and constant blood in my urine. I just had kidney a biopsey done. The results show i have moderate tubular atrophy, my arteries have intimal fibrosis and arterioles display muscular hypertrophy and hyalinization. I don't understand what these results mean, and was told by my kidney doctor I don't need to worry. i have two beautiful children. my mom passed away from sle, and breast cancer in 1985. i know there is something wrong with me, and I'm scared. what should I do.
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john-skpt responded:
I'm not sure that there is yet a definite pattern of findings that indicates SLE. Hyaline casts or thromboses are common in SLE, but that doesn't exactly sound like what your biopsy report shows. Hyaline can also show up in some cases of diabetes and in some prescription drug effects. Other autoimmune conditions can be a cause.

The elevated ANA is a bit concerning, as are the vascular changes seen in the kidney.

I'm just unsure of whether you would be better off seeing the rheumatologist again or maybe shifting to a nephrologist for a consultation.
 
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dselin68 replied to john-skpt's response:
Thank you so much for the reply. My kidney specialist said out of 14 glomeruli, i had 4 glomeruli that are globally sclerotic, and the remainder show wrinkling. i also have a few subepithelial lucencies in my capillary walls. She then went on to say my Paramesangial basement membranes show mild to moderate corrugation. She doesn't explain things well, but went on to say they don't know what causes this, and there was nothing they could really do, and I didn't need to see her again. she said that i would just have to live with the pain, and constant blood in my urine.
 
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john-skpt replied to dselin68's response:
Well, that "just live with it" comment isn't very comforting, but at least they have a biopsy sample to use as a baseline. There might not be a lot of direct treatment options, but I think that the docs should do some routine monitoring as time passes, and then treat any symptoms that arise.


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