Lupus nephropathy
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Keywords

Lupus
Nephritis
Nephrotic Syndrome
Proliferative glomerulonephritis.

How to Cite

1.
Pinto Peñaranda LF. Lupus nephropathy. Rev. Colomb. Nefrol. [Internet]. 2014 Jul. 1 [cited 2024 Mar. 29];1(2):104-17. Available from: https://revistanefrologia.org/index.php/rcn/article/view/182

Abstract

Lupus nephritis (LN) occurs between 30% and 70% of patients with systemic lupus erythematosus (SLE), depending on race and sex. LN appears early in the disease with prevalence of severe forms such as classes III, IV and mixed (V + III IV or V +). 50% of adults and 70% of children with lupus born in Colombia, suffer LN sometime in their lifetime; in this population 25% of children and 38% of adults have nephrotic syndrome. The remission rate at six months is low, the proteinuria in nephrotic range, and the incraease of baseline creatinine predict failure to achieve remission at 6 months.
https://doi.org/10.22265/acnef.1.2.182
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References

1. Tan EM, Cohen AS, Fries JF, Masi A, Mc Shane D,Rothfield N, et al. The 1982 revised criteria for classification Systemic Lupus Erythematosus. Arthritis & Rheum 1982;25:1271-1277.

2. Hahn BH, Mc Mahon M, Wilkinson A, Wallace D, Daikh D, Fitzgerald J, et al. American College of Rheumatology guidelines for screening, treatment and manegement of Lupus Nephritis. Athritis Care Res. 2012;64:797-808.

3. Bertsias G, Tektonidou M, Amoura Z, Aringer M, Bajema I, Benden J, et al. Joint European Leage Against Rheumatism and uropean Association- European Dyalisis and Trasplant Association (EULAR/ERA-EDTA) recommedations for the manegement of adult and pediatric Lupus Nephritis. Ann Rheum Dis 2012;71:1771- 782.

4. Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, et al. Derivation and Validation of the Systemic Lupus Erythematosus international collaborating clinics classification criteria for Systemic Lupus Erythematosus. Arthritis Rheum 2012;64:2677-2686.

5. Cervera R, Khamastha M, Font J, Sebastiani JD, Gil A, La Villa P, et al. Systemic Lupus Erythematosus: Clinical and Immunologic patters of disease expression in a cohort of 1000 patients. Medicine 1993;72:113-124.

6. Arbuckle MR, James JA, Denis GJ, Rubertone MV, Mc Clain MT, et al. Rapid clinical progression to diagnosis among African- merican men with Systemic Lupus Erythematosus. Lupus 2003;12:99-106.

7. López P, Mozo L, Gutiérrez C, Suárez A. Epidemiology of Systemic Lupus Erythematosus in a northern Spanish Population: Gender and Age influences in immunologic features. Lupus 2003;12:860-865.

8. Pons-Estel B, Catoggio L, Cardiel M, Soriano E, Gentilitti S, Villa A, et al. The GLADEL multinational Latin American Prospective Inception Cohort of 1214 patients with Systemic Lupus Erythematosus. Medicie 2004;83:1-18.

9. Bertoli A, Alarcón GS, Calvo-Alen J, Fernández M, Vila L, Reveille for the LUMINA study group. Systemic Lupus Erythematosus in a multicentric US cohort. Clinical features, course and outcome kin patients with late onset disease. Arthritis Rheum 2006;54:1560-1567.

10. Pinto LF, Guerra L, González JR, Pérez A, Velásquez CJ, Felipe O, et al. Lupus Eritematoso Sistémico: análisis del comportamiento clínico en una población de Medellín. Rev Col Reum 1997;4:170- 73.

11. Senior JM, Pinto LF, Uribe O, Felipe O, Ramírez LA. Nefritis Lúpica: Correlación clínico-patológica y respuesta a pulsos de ciclofosfamida. Rev Col Reum 1994;1:19-27.

12. Ruiz O, Londoño J, Vélez P, Ortiz I, Motta L, Valle R. Descripción de una cohorte de pacientes con Lupus Eritematoso Sistémico (LES) en un hospital de Bogotá-Colombia. Rev Col FReum 2003;10:266-275.

13. Ramírez–Gómez LA, Builes CA, Maya C, Palacio CA, Velásquez JF, Uribe O. Lupus Eritematoso Sistémico en niños. Rev Col Reum 1998;5:11-17.

14. Martins L, Rocha G, Rodríguez A, Santos J, Vasconcelos C, Correia J, et al. Lupus Nephritis: A restrospective review of 78 cases from a single center. Clin Nephrol 2002;57:114-119.

15. Mc Gowan JR, Ellis S, Griffiths M, Isenberg D. Retrospective analysis of outcome in a cohort of patients with Lupus Nephritis treated betwen 1997 and 1999. Rheumatology 2002;41:981-987.

16. Ortega LM, Schultz DR, Lens O, Pardo V, Contreras G, et al. Lupus Nephritis: Pathologic features, epidemiology and guide to therapeutic decisions. Lupus 2010;19:567-574.

17. Pinto LF, Castro IL, Duque V, Márquez J, Velásquez CJ. Factores de riesgo predictores de falla a la terapia de inducción de nefritis lúpica en una cohorte de pacientes colombianos. Reumatología Clínica 2014;10:147-151.

18. Pinto LF, Márquez JD, Velásquez CJ, Duque V. Lupus Nephritis: Description of a cohort of hispanic patients and detection of remission predictors at 12 months. Lupus 2013;22:1-86,P094.

19. Pinto LF, Velásquez CJ, Prieto C, Mestra L, Forero E, Márquez JD. Rituximab induces a rapid and sustained remission in colombian patients with severe and refractory Systemic Lupus Erythematosus. Lupus 2011;20:1219-1226.

20. Sunder R, Solomons, Lisk L, for the Aspreva Lupus Management Study (ALMS) group. Efficacy of Mycophenolate Mofetil in adolescent patients with Lupus Nephritis: Evidence from a two-fhase prospective randomized trial. Lupus 2012;21:1433- 443.

21. Perfumo F, Martin A. Lupus Nephritis in children. Lupus 2005;14:83-88.

22. Markowitz GS, D`agati VD. The ISN/RPS classification of the glomerulonephritis in Systemic Lupus Erythematosus Revisited. J Am Soc Nephrol 2004;15:241-250.

23. Ruiz-Irastorza G, Espinosa G, Frutos M, Jiménez-Alonso J, Praga M, Pallares L, et al. Diagnóstico y tratamiento de la nefritis lúpica. Nefrología 2012;32(SUPPL 1):1-35.

24. Nochi D, Daugas E, Droz D, Beausfils H, Grünfeld JP, Piette JC, et al. The intrarrenal vascular lesions associated with primary antiphospholid síndrome. Journal Of Am Soc Nephrol 1999;10:507- 18.

25. Daugas E, Nochi D, Hupong D, Duchat P, Beausfil H, Cadwell V, et al. Antiphospholipid syndrome nephropaty in Systemic Lupus Erythematosus. Journal Of Am Soc Nephrol 2002;13:42-52.

26. Nesher G, Hanna VE, Moore TL. Thrombotic Microangiophatic Hemolitic Anemia in Systemic Lupus Erythematosus. Sem SArth Rheum 1994;24:165-172.

27. Weening JJ, Dàgati VD, Schwartz M, Seshan S, Alpers Ch, Appel G. The calassification of glomerulonephritis in Systemic Lupus Erythematosus. Kidney Int 2004;65:521-530.

28. Churg J, Sobin LH: Renal Disease. Classification and Atlas of glomerular diseases Tokio, Igaku – Shoin, 1982.

29. Churg J, Bernstein J, Glassock PJ. Renal Disease. Classification and Atlas of glomerular diseases 2nd Ed, New York,Igaku – Shoin 1995.

30. Pirani CL, Pollack VE, Schwartz FD: The Reproductibility of semicuantitative analysis of renal histology. Nephron 1964;1:230-237.

31. Haas M, Rastaldi M, Fernenz A. Histologic Classification of the glomerular diseases: clinic-pathologic correlation limitations exposed by validation studies and suggestions of modification. Kidney Int 2014;85:779-793.

32. Contreras G, Pardo V, Cely C, Borja E, Hurtado A, De la Cuesta C. Factors associated with poor outcomes in patients with Lupus Nephritis. Lupus 2005;14:890-895.

33. Najafi CC, Korbet M, S, Lewis E, Schwartz M, Reichlin M. Significance of histologic patterns of glomerular injury upon long- erm prognosis in severe lupus glomerulonephritis. Kidney Int 2001;59:2156-2163.

34. Austin HA III, Boumpas DT, Vaughan EM, Ballow JE. High-risk features in Lupus Nephritis: importance of race and clinical and histological factors in 166 patients. Nephrol Dyal Trasplant 1995;10:1620-1628.

35. Taraborelli M, Andreoli L, Tincani A. Munch more tan thromboses and pregnancy loss: The Antiphospholipid Syndrome as a sistemic disease. Best Pract Clin Rheumatol 2012;26:79-90.

36. Alchi B, Griffiths M, Jayne D. Wath Nephrologist need to know about antiphospholipid syndrome. Nephrol Dyal Trasplant 2010;25:3147-3154.

37. Mesa M, Saldarriaga C, Aguilar C, Builes C, Quiroga A, Aristizabal N, et al. Síndrome antifosfolípido: descripción de una cohorte de pacientes colombianos y evaluación de los factores de riesgo para trombosis. Rev Col Reum 2012;19:208-217.

38. Granda P, Restrepo M, Velásquez CJ, Pinto LF, Márquez J, Mejía R et al. Hemorragia alveolar difusa y nefropatía en dos pacientes con síndrome antifosfolípido primario. Rev Col Reum 2011;16:68-74.

39. Espinosa G, Bucciarelli S, Cervera R, Lozano M, Reverter JC, de la Red G, et al. Thrombotic microangiophatic haemolytic anemia and antiphospholipid antibodies. Ann Rheum Dis 2004;63:730-736.

40. Hu WX, Liu ZZ, Chen HP, Zhang HT, Li S, Liou ZH. Clinical Characteristics and prognosis of diffuse proliferative Lupus Nephritis with thrombotic microangiopathy. Lupus 2010;19:1591-1598.

41. Bridoux X, Vrtovsnik F, Noel C, Saunier P, Mougenot B, Lemaitre V, et al. Renal Thrombotic microangiopathy in systemic lupus erythematosus. Clinical correlations and long-term renal survival. Nephrol Dyal Trasplant 1998;13:298:304.

42. Yao G, Hu WX, Liu ZH, Chen HP, Zhang HT, Li LS. The significance of renal vasculopathy in patients with diffuse proliferative lupus nephritis. Nephrol Dyal Trasplant 2002;11:211-219.

43. Schwartz M, Korbet S, Lewis E (For the collaborative study group) The prognosis and pathogenesis of severe Lupus Glomerulonephritis. Nephrol Dyal Tasplant 2008;23:1298-1306.

44. Behara V, Whittier W, Korbet S, Schwartz M, Martens M, Lewis E. Pathogenetic features of severe segmental Lupus Nephritis. Nephro Dyal Trasplant 2010;25:153-159.

45. Gill GF, Dellahouse M, Nochy D, Bariety J. Class IV-S versus IV-G Lupus Nephritis: Clinical and morphologic differences suggesting different pathogenesis. Kidney Int 2005;68:2288-2297.

46. Masani N, Imbriano L, D`agati V, Markowitz G. SLE and Rapidly Progressive Glomerulonephritis. Am J Kid Dis. 2005;45:950-955.

47. Nasr S, D`agati V, Park HR, Sterman P, Goyzueta J, Dressler R, et al. Necrotizing and Crescentic Lupus Nephritis with Antineutrophil Cytoplasmic Antibody Seropositivity. Clin J Am Soc Nephrol 2008;3:682-690.

48. Markowitz GS, D`agati VA. Classification of Lupus Nephritis. Curr Op Nephrol Hypert 2009;18:220-225.

49. Yu F, Tan Y, Lui G, Wang SX, Zou WZ, Zhao MH. Clinicophatological characteristics and outcome of patients with crescentic lupus nephritis. Kidney Int 2009;76:307-317.

50. Abedallatif AA, Warris S, Lakhani A, Kadikoy H, Haque W, Truong LD. True vasculitis in Lupus Nephritis. Clin Nephrol 2010;74:106-112.

51. Appel GB, Pirani CL, D`agati V. Renal vascular complications in Systemic Lupus Erythematosus. J Am Soc Nephrol 1994;4:1499-1515.

52. Descombes E, Droz D, Drouet L, Grunfeld JP, Lesavre P. Renal vascular lesions in Lupus Nephritis. Medicine 1997;76:355-368.
53. Chu H, Wu LH, Song D, Yu F, Zhao MH. Non inflammatory necrotizing vasculopathy in Lupus Nephritis. A single center experience. Lupus 2014;23:20-30.

54. Wang J, Hu W, Xie H, Zhang H, Chen H, Zeng C, et al. Induction therapies for class IV Lupus Nephritis with non inflammatory necrotizing vasculopathy: Mycophenolate Mofetil or intravenous cyclophosphamide. Lupus 2007;16:707-712.

55. Christopher-Stine L, Siedner M, Lin J, Haas M, Perekh H, Petri M, et al. Renal biopsy in patients with low levels of proteinuria. J Rheumatol 2007;34:1491-1496.

56. Oates J. Renal biopsy at the onset of clinical lupus nephritis: Can it yield useful information? J Rheumatol 2007:34:256-257.

57. Houssiau F, Vaconcelos C, D`Cruz D, Sebastiani JD, De Ramón E, Danielli M, et al. Immunosuppresive therapy in lupus nephritis. The Eurolupus Nephritis Trial, a Randomized Trial of low-doses versus high-doses intravenous cyclophosphamide. Arthritis Rheum 2002;46:2121-2131.

58. Austin III HA, Boumpas D, Vaughan H, Ballow J. Predicting renal outcomes in severe lupus nephritis: contribution of clinical and histologic data. Kid Int 1994;45:544-550.

59. Arce-Salinas CA, Villa AR, Martínez-Rueda JO, Muñoz L, Cardiel MH, Alcocer-Varela J, et al. Factors associated with chronic Renal Failure in 121 patients with lupus nephritis a case-control study. Lupus 1995;4:197-203.

60. Korbet S, Lewis E, Schwartz M, Reichlin M, Evans J, Rhonde R, et al. Factors Predictive of outcome in severe lupus nephritis. Am J Kid Dis 2000;35:904-914.

61. Mok CC, Ho CT, Chan KW, Law GS, Wong RW. Outcome and prognostic indicators of diffuse proliferative Lupus Glomerulonephritis treated with sequential oral cyclophosphamide and azathioprine. Arthritis Rheum 2002;46:1003-1013.

62. Mok CC. Prognostic factors in Lupus Nephritis. Lupus 2005;14:39-44.

63. Flower C, Hennis A, Hambleton IR, Nicholson G. Lupus Nephritis in afro-caribbean population: Renal indices and clinical outcome. Lupus 2006;15:689-694.

64. Gibson K, Gipson D, Massengill S, Dooley MA, Primack W, Ferris M, et al. Predictors of relapse and end stage kidney disease in proliferative lupus nephritis: Focus on children, adolescents and Young adults. Clin J Am Soc Nephrol 2009;4:1962-1967.

65. Moon SJ, Kwok SK, Ju JH, Park KS, Park SH, Cho CS, et al. Predictors of chronic kidney disease in Korean patients with lupus nephritis. J Rheumatol 2011;38:2588-2597.

66. So MW, Koo SB, Kim YG, Lee ChK, Yoo B. Predictive value of remission status after 6-month induction therapy in patients with proliferative Lupus Nephritis. A retrospective analysis. Clin Rheumatol 2011;30:1399-1405.

67. Levey AS, Lan SP, Corwin HL, Kasinath BS, Lachin J, Nielson EG, et al. Progression and remission of renal disease in Lupus Nephritis collaborative study: Results of treatment with prednisone and short-term oral cyclophosphamide. Ann Int Med 1992;116:114-123.

68. Fraenkel L, Hayslett JP, Esdaile J. Response to treatment as predictor of long-term outcome in patients with Lupus Nephritis. J Rheumatol 1994;21:2052-2057.

69. Houssiau F Vasconcelos C, D`Cruz D, Sebastiani GD, De Ramón-Garrido ER, Danielli MC, et al. Early response to immunosuppressive therapy predicts good renal outcome in Lupus Nephritis. Lessons from long-term follow-up of patients in Eurolupus Nephritis Trial. Arthritis Reum 2004;50:3934-3940.

70. The American College of Rheumatology Response Criteria for Proliferative and Membranous Renal Disease in Systemic Lupus Erythematosus Clinical Trials. Arthritis Rheum 2006;54:421-432.

71. Austin III HA, Klipel JH, Ballow J, Le Riche N, Steimberg A, Plotz P, et al. Therapy for Lupus Nephritis Controlled Trial of prednisone and cytotoxic drugs. N Eng J Med 1986;314:614-619.

72. Lai K, Sydney C, Mok CC. Treartment for Lupus Nephritis. A Revisit. Nephrol 2005;10:180-188.

73. Illei G, Austin III H, Crane M, Collins L, Gourley M, Yarboro Ch, et al. Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improve long-term renal outcome without adding toxicity in patients with Lupus Nephritis. Ann Int Med 2001;135:248-257.

74. Houssiau F Vasconcelos C, D`Cruz D, Sebastiani GD, De Ramón-Garrido ER, Danielli MC, et al. The 10-year Follow- up data of the Eurolupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide. Ann Rheum Dis 2010;69:61-64.

75. Appel GB, Contreras G, Dooley MA, Ginzler E, Isenberg D, Jayne D, et al. Mycophenolate Mofetil versus cyclophosphamide for induction treatment of Lupus Nephritis. J Am Soc Nephrol 2009;20:1103-1112.

76. Ginzler EM, Dooley MA, Arnow C, Kim M, Buyon J, Merrill JT, et al. Mycophenolate Mofetil or intravenous cyclophosphamide for Lupus Nephritis. N Eng J Med 2005;353:2219-2228.

77. Chan TM, Li FK, Tang CS, Wong R, Fang G, Ji Y, et al. Efficacy of Micophenolate Mofetil in patients with Diffuse Proliferative Lupus Nephritis. Hong Kong Guangzhou Nephrology Study Group. N Eng J Med 2000;343:1156-1162.

78. Ong M, Hooi LS, Tim TO, Go BL, Ahmad G, Ghazalli R. et al. Randomized controlled trial of pulse intravenous cyclophosphamide versus mycophenolate mofetil in the induction therapy of proliferative Lupus Nephritis. Nephrol 2005;10:504-510.

79. Touma Z, Gladman D, Urowitz M, Beyene J, Ulerik E, Shah P. Mycophenolate mofetil for induction treatment of lupus nephritis: A systematic review and meta-analysis. J Rheumatol 2011;38:69-78.

80. Henderson L, Masson P, Craig J, Roberts M, Flanc R, Strippoli G. Induction and Maintenance Treatment of proliferative Lupus Nephritis: A meta-analysis of randomized controlled trials. Am J Kidney Dis 2013;61:74-87.

81. Walsch M, Solomons N, Lisk L, Jayne D. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis with por kidney function: A subgroup Analysis of ASPREVA lupus manegement study. Am J Kidney Dis 2013;61:710-715.

82. Tang Z, Yang G, Yussheng Y, Jinquan W, Weixin H, Zeng C, et al. Effect of mycophenolate mofetil for patients with crescentic lupus nephritis. Neprol 2008;13:702-705.

83. Wang J, Hu W, Zhang H, Chen H, Zeng C, Liu Z, et al. Induction therapies for class IV Lupus Nephritis with non- nflammatory necrotizing vasculopathy: Mycophenolate mofetil or intravenous cyclophosphamide. Lupus 2007;16:707-712.

84. Marimoto S, Watanabe T, Lee S, Amano H, Kammaro Y, Ohsawa I, et al. Improvement of rapidly progressive lupus
nephritis aasociated MPO-ANCA with tacrolimus. Mod Rheumatol 2010;20:291-294.

85. Yap D, Ma M, Mok M, Tang C, Chan TM. Long-term data on corticosteroids and Mycophenolate mofetil treatment in Lupus Nephritis. Rheumatol 2013;52:480-486

86. Contreras G, Pardo V, Leclerq B, Lenz O, Tozman E, O`nan P, et al. Sequential therapies for proliferative lupus nephritis. N Eng J Med 2004:350:971-980.

87. Dooley MA, Jayne D, Ginzler E, Isenberg D, Olsen N, Wofsky D et al. Mycophenolate versus azathioprine an maintenance therapy for Lupus Nephritis. N Eng J Med 2011;365:1886-1895.

88. Houssiau FA, D`Cruz D, Sangle S, Remy P, Vasconcelos C, Petrovic R. Azathioprine versus mycophenolate mofetil for long-term immunosuppression in Lupus Nephritis: Results from the MAINTAIN nephritis trial. Ann Rheum Dis 2010;69:2083-2089.

89. Chan TM, Tse KC, Tang CS, Mok MY, Li FK. Long-term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative Lupus Nephritis. J Am Soc Nephrol 2005;16:1076-1084.

90. Feng Li, Deng J, Huo DM, Wu QY, Liao YH. Mycophenolate mofetil versus azathioprine as maintenance therapy for Lupus Nephritis: A meta-analysis. Nephrol 2013;18:104-110.

91. Rovin B, Furie R, Latinis K, Looney J, Fervenza F, Sánchez- uerrero J, et al. Efficacy and safety of rituximab in patients with active proliferative Lupus Nephritis, Arthritis Rheum 2012;64:1215-1226

92. Díaz-Lagares C, Croca S, Sangle S, Vital E, Catapano F, Martínez-Berriotxa A, et al. Efficacy of Rituximab in 164 patients with Biopsy proven lupus nephritis: Pooled data from european cohorts. Autoimm Rev 2012;11:357-364.

93 Jondasttir T, Gunnarson I, Mourao A, Lu T, Van Vollenhoven R, Isenberg D. Clinical improvement in proliferative versus membranous lupus nephritis following B cell depletion: pooled data from two cohorts. Rheumatol 2010,49:1502-1504.

94. Terier B, Amoura Z, Ravaud P, Hachulla E, Jovenne R, Combe B, et al. Safety and efficacy of rituximab in Systemic Lupus Erythematosus. Results from 136 patients from the french autoimmunity and rituximab registry. Arthritis Rheum 2010;62: 2458-2466.

95. García–Carrasco M, Mendoza-Pinto C, Sandoval-Cruz M, Soto- ega E, Beltrán-Castillo A, Jiménez-Hernández M, et al. Anti-CD20 therapy in patients with refractory systemic lupus erythematosus: A longitudinal analysis of 52 hispanics. Lupus 2010;19:213-219.

96. Melander C, Sallee M, Trolliet P, Candon S, Belenfant X, Daugas E, et al. Rituximab in severe lupus nephritis: Early B cell depletion affects, long-term renal outcome. Clin J Am Soc Nephrol 2009;4:579-587.

97. Moroni G, Raffiotta F, Trezi B, Giglio E, Mezzina N, Delpapa N, et al. Rituximab versus Mycophenolate Mofetil versus Cyclophosphamide pulses for induction therapy of active lupus nephritis: A clinical observational study. Rheumatol 2014;53:1570-1577.

98. Condon M, Ashby D, Peeper R, Cook H, Levy J, Griffith M, et al. Prospective observational single-center cohort study to evaluate the effectiveness of treating Lupus Nephritis with rituximab and mycophenolate but no oral steroids. Ann Rheum Dis 2013;72:1280-1286.

99. Li E, Tam LS, Zhu T, Li M, Kwok K, Li T. Is combination rituximab with cyclophosphamide better tan rituximab alone in the treatment of Lupus Nephritis? Rheumatol 2009;48:892-898.

100. Ramos-Casals M, SDoto MJ, Cuadrado MJ, Khamashta M. Rituximab in Systemic Lupus Erythematosus: A systematic review of off-label use in 188 cases. Lupus 2009;18:767-776.

101. Ogawa H, Kameda H, Nagasawa H, Sekiguchy N, Takei H, Tzuzaka K, et al. Prospective study of low-dose cyclosporine in patients with refractory Lupus Nephritis. Mod Rheumatol 2007;17:92-97.

102. Fesser BJ, Alarcón GS, Mc Gwin F Jr, Roseman J, Bastian HM, Friedman AW, et al. For the LUMINA Study Group. Systemic Lupus Erythematosus in three etnic groups. XVI. Association of hydroxicholoquine use with reduced risk of damage accrual. Arthritis Rheum 2005;52:1473-1480.

103. Pons-Estel GJ, Alarcón GS, McGwin G Jr, Danila MI, Zhang J, astian HM, et al. For the LUMINA Study Group. Protective effect of hydroxichloroquine of renal damage in patients with Lupus Nephritis: LXV. Data from, a multietnic US cohort. Arthritis Rheum 2009; 61:863-868.
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