An international consensus committee described features for the antiphospholipid syndrome and related conditions. One of the related conditions is nephropathy.


NOTE: A patient who meets the clinical criteria (vascular thromboses and/or pregnancy morbidity) for the antiphospholipid syndrome is excluded from the definition.



(1) laboratory features of the antiphospholipid syndrome, with the presence of:

(1a) lupus anticoagulant

(1b) anticardiolipin antibody

(1c) anti-beta-glycoprotein I antibody

(1d) mixture of 2 or more types

(2) presence of one or more of the following on renal biopsy:

(2a) thrombotic microangiopathy involving both glomerular capillaries and arterioles

(2b) fibrous intimal hyperplasia involving organized thrombi

(2c) fibrous and/or fibrocellular occlusions of arteries and arterioles

(2d) focal cortical atrophy

(2e) areas of atrophic tubules containing eosinophilic casts ("tubular thyroidization")

(3) exclusion another explanation for the renal disease including:

(3a) vasculitis

(3b) thrombotic thrombocytopenic purpura (TTP)

(3c) hemolytic uremic syndrome (HUS)

(3d) malignant hypertension



• Focal cortical atrophy can be seen in many adult kidneys, so by itself is probably not a good indication of a nephropathy.


If the patient has SLE, then the lesions should be distinguished from those of lupus nephropathy (both conditions may co-exist).


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