Renal vascular complications of systemic lupus erythematosus.

enal vascular complications are not infrequently encountered in systemic lupus crythematosus (SLE), and their occurrence can have a profound effect on the clinical course and choice of therapy. A variety of histopathologic lesions of the renal vessels as well as a number of distinct clinical syndromes related to vascular damage may occur In SLE. These renal vasculopathies include vascular Immune complex deposition, noninflammatory necrotizing vasculopathy, thrombotic microangiopathy, and true renal vasculitis. The clinical syndromes of thrombotic thrombocytopenic purpura (TTP), anticardiolipin syndrome, and renal vein thrombosis (RVT) are also well-documented vascular coinplications of SLE. Because glomerular pathology is of primary importance in the classification of lupus nephritis, the presence and significance of these vascular lesions are often overlooked. Although the pathogenesis of many of these vascular entities is not fully defined, therapeutic intervention has often been successful. This article reviews their pathology, pathogenesis, epidemiology, and clinical course, as well as the various therapeutic strategies used to treat the vascular complications of SLE.