Nefropatía lúpica silente

Silent lupus nephritis (SLN) is an unusual clinical presentation of lupus nephritis (LN) and may be an underdiagnosed entity. Renal biopsy is the only diagnostic method but is invasive and is not indicated in asymptomatic patients. Consequently, the prevalence of this disease is difficult to determine. Data from more than 250 SLN cases published in the literature were analyzed from isolated cases, case studies and prospective studies. Of the 226 well-described cases, we selected 197 reported after the 1970s. Patients with class I lesions (n = 29, 15%) were excluded as they fell outside the definition of SLN. Among included patients, there were 107 with class II (54.3), 45 with class III (22.8%), 50 with class IV (25.4%), 9 with class V (4.6%) and one with class VI. Forty percent had proliferative forms (classes III and IV), the most severe forms of LN.

Of the 197 patients, 65 patients (33%) from six publications were followed-up. The data did not allow conclusions to be drawn on the epidemiology or prognosis of this entity. Future studies are required to clarify these issues.