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Letter
Anticoagulation in patients with concomitant lupus nephritis and thrombotic microangiopathy: a multicentre cohort study
  1. Savino Sciascia1,2,
  2. Jinoos Yazdany3,
  3. Maria Dall'Era3,
  4. Roberta Fenoglio2,
  5. Massimo Radin1,
  6. Ishita Aggarwal3,
  7. Maria J Cuadrado4,5,
  8. Karen Schreiber5,6,7,
  9. Antonella Barreca8,
  10. Mauro Papotti8,
  11. Dario Roccatello1,2
  1. 1 Center of Research of Immunopathology and Rare Diseases- Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
  2. 2 SCU Nephrology and Dialysis(ERKnet member), S. Giovanni Bosco Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
  3. 3 Division of Rheumatology, Russell/Engleman Research Center, University of California, San Francisco, California, USA
  4. 4 Lupus Unit, Department of Rheumatology, Guy's and St Thomas' Hospital, London, UK
  5. 5 Department of Thrombosis and Haemophilia, Guy's and St Thomas' Hospital, London, UK
  6. 6 King Christian X’s Rheumatology Hospital, Graasten, Denmark
  7. 7 Copenhagen Lupus and Vasculitis Clinic, Center for Rheumatology and Spine Diseases, Copenhagen, Denmark
  8. 8 Division of Pathology, Department of Medical Sciences, University of Turin, Turin, Italy
  1. Correspondence to Dr Savino Sciascia, Center of Research of Immunopathology and Rare Diseases- Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, Department of Clinical and Biological Sciences, University of Turin, Turin 10154, Italy; savino.sciascia{at}unito.it

https://doi.org/10.1136/annrheumdis-2018-214559

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    The management of lupus nephritis (LN) and concomitant thrombotic microangiopathy (TMA), with or without antiphospholipid antibodies (aPL), remains controversial, and few studies are available to inform clinical management.1–4

    The purpose of this multicentre retrospective study was to analyse the impact of anticoagulation (vitamin K antagonists (VKAs) and/or heparins) in addition to conventional immunosuppression on kidney outcomes (assessed at 12 months, according to the Kidney Disease: Improving Global Outcomes-KDIGOguidelines5) in patients with biopsy-proven LN and concomitant TMA.

    Data source, population and statistical analysis are detailed in the online supplementary material 1. Anticoagulation was considered if given for at least three consecutive months after TMA diagnosis.

    Supplemental material

    [annrheumdis-2018-214559supp002.docx]

    We retrospectively identified 97 patients with biopsy-proven LN and TMA (2007–2017). See online supplementary table 1 for clinical and demographic characteristics. Laboratory parameters were collected at the time of the biopsy. The mean age of patients was 38.9±15.2 years (13–69) and 85 females (87.6%). Most had proliferative LN (class …

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