Results of a worldwide survey on the currently used histopathological diagnostic criteria for invasive lobular breast cancer.

Invasive lobular carcinoma (ILC) represents the second most common subtype of breast cancer (BC), accounting for up to 15% of all invasive BC. Loss of cell adhesion due to functional inactivation of E-cadherin is the hallmark of ILC. Although the current world health organization (WHO) classification for diagnosing ILC requires the recognition of the dispersed or linear non-cohesive growth pattern, it is not mandatory to demonstrate E-cadherin loss by immunohistochemistry (IHC). Recent results of central pathology review of two large randomized clinical trials have demonstrated relative overdiagnosis of ILC, as only ~60% of the locally diagnosed ILCs were confirmed by central pathology. To understand the possible underlying reasons of this discrepancy, we undertook a worldwide survey on the current practice of diagnosing BC as ILC. A survey was drafted by a panel of pathologists and researchers from the European lobular breast cancer consortium (ELBCC) using the online tool SurveyMonkey®. Various parameters such as indications for IHC staining, IHC clones, and IHC staining procedures were questioned. Finally, systematic reporting of non-classical ILC variants were also interrogated. This survey was sent out to pathologists worldwide and circulated from December 14, 2020 until July, 1 2021. The results demonstrate that approximately half of the institutions use E-cadherin expression loss by IHC as an ancillary test to diagnose ILC and that there is a great variability in immunostaining protocols. This might cause different staining results and discordant interpretations. As ILC-specific therapeutic and diagnostic avenues are currently explored in the context of clinical trials, it is of importance to improve standardization of histopathologic diagnosis of ILC diagnosis.

Ketamine-induced cystitis: A case report and literature review.

Ketamine, a dissociative anesthetic drug, has gained popularity as a recreational substance, particularly among young adults. However, chronic ketamine abuse can lead to various complications including ketamine-induced cystitis. We present the case of a 46-year-old Caucasian male with a history of HIV infection and daily recreational ketamine use for 7 months, who was admitted to the emergency room with hypogastric pain and hematuria. Laboratory examinations and contrast-enhanced abdominal CT tomography revealed significant irregular circumferential thickening of both ureters, substantial bilateral pyeloureteral ectasia, and a bladder with markedly thickened walls. Bilateral flexible ureteropyeloscopy, bladder transurethral resection, and bladder fulguration were performed, and pathology confirmed the diagnosis of ketamine-induced cystitis. Treatment consisted of ketamine withdrawal, pain relief, and support from psychiatrists and urologists. The patient's symptoms improved and he was discharged without complications. This case highlights the importance of recognizing the potential adverse effects of recreational ketamine use and the need for a multidisciplinary approach to managing ketamine-induced cystitis. Further research is necessary to elucidate the precise mechanisms underlying this condition and develop effective prevention and treatment strategies.

Tall Cell Carcinoma With Reversed Polarity of the Breast.

Tall cell carcinoma with reversed polarity (TCCRP) of the breast is a rare entity with low potential for malignancy that exhibits some morphological similarities to the tall cell variant of papillary thyroid carcinoma. Immunohistochemical and molecular studies help establish the mammary origin of this neoplasm. Here, we describe the case of a 63-year-old woman with a finding of a nodular lesion during a screening mammogram, whose morphological findings and immunohistochemical studies confirmed the diagnosis of papillary high cell carcinoma with the reverse polarity of the mammary gland.

A Classic Presentation of Desmoplastic Small Round Cell Tumor.

Desmoplastic small round cell tumor (DSRCT) is a rare malignancy, of uncertain differentiation, which more commonly affects adolescents and young adult males; it usually has an intra-abdominal location. We describe the case of a 35-year-old male who presented initially with occasional abdominal pain, and subsequently with abdominal mass sensation, without any other associated symptoms. Imaging studies reported an intra-abdominal mass located in mesogastrium, right hypochondrium, and right lumbar region, without clear evidence of infiltration to secondary structures, but with clear peritoneal spread to greater omentum and pelvis. Definitive diagnosis of DSRCT is based on histologic and immunohistochemical findings. Standard treatment includes intensive neoadjuvant chemotherapy, surgical cytoreduction, and radiotherapy. Despite this multidisciplinary approach, DSRCT has a poor prognosis and a high mortality rate at five years.

Mediastinal Hibernoma: A Rare Cause of Chronic Cough.

A hibernoma is an uncommon benign soft tissue tumor composed of brown adipose cells; the mediastinal location as presentation is scarce, with only six cases previously reported. The diagnosis of hibernoma is challenging and must be made based on the clinical, radiographic, and cytologic features. Here we present a 33-year-old woman without any relevant medical history presented for outpatient evaluation of a dry cough persisting for three months, and the X-rays revealed a dense well-defined mass with smooth borders in the left upper posterior mediastinum.  Posterior mediastinal lesions represent a relatively small proportion of patient loads in thoracic surgery and account for a total of 25% of the cases, with neurogenic tumors among the most frequently seen in adults. Of these, the nerve sheath tumors (schwannoma, neurofibroma, paraspinal ganglioneuroma) are the most seen. Other differential diagnoses of paravertebral masses are the paraspinal abscess, metastases, hematoma, descending aortic aneurysm, among others. The patient underwent surgical resection via left posterolateral thoracotomy, without complications.

Tuberculosis in patients treated with tumor necrosis factor-alpha antagonists living in an endemic area. Is the risk worthwhile?

Tumor necrosis factor alpha antagonists (TNFA) are biological agents to treat chronic inflammatory and autoimmune diseases. However, their use is associated with an increased rate of tuberculosis, endemic mycoses, and intracellular bacterial infections. Since tuberculosis is moderately to highly endemic in Colombia, the risk of these infections in patients treated with TNFAs may be higher than previously reported in Colombia. Recently, four patients have developed tuberculosis during TNFA therapy. Tuberculosis appeared between 3 to 24 months after initiation of TFNA therapy and was independent of previous tuberculin skin test status. A review of the relevant literature and recommendations are presented as guides for surveillance and prophylaxis on a country-wide basis.

Clinical and immunological factors associated with lupus nephritis in patients from northwestern Colombia.

A cross-sectional and multicenter study was undertaken to analyze the clinical and immunological characteristics at diagnosis associated with nephritis in northwestern Colombian patients with systemic lupus erythematosus (SLE). Thirty-nine patients with lupus nephritis were included and were compared to 100 SLE patients without nephritis. A multivariate analysis was performed. The patients who developed nephritis had a higher frequency of oral ulcers (41% vs. 21%, OR = 3.1, 95% CI: 1.3-7.5 p = 0.01) and malar erythema (77% vs. 45%, OR = 4.4, 95% CI: 1.8-10.8 p = 0.001). Lupus nephritis was observed in 77% of cases during the first year of the disease. The frequency of anti-DNA antibodies was higher in patients with nephritis, however, differences were not statistically significant (83% vs 64%, OR = 2.6, 95% CI: 1.03-6.41, p = 0.06). The presence of other autoantibodies (anti-Ro, anti-La, anti-RNP, anti-Sm and anticardiolipin) at diagnosis was similar in both groups. This autoantibody profile remained unchanged throughout the evolution of the disease. Patients with lupus nephritis had a higher prevalence of arterial hypertension (60% vs 10%, OR = 13.7, 95% IC: 5-37, p = 0.00001) and hyperlipidemia (30% vs 7%, OR = 8.1, 95% IC: 2.5-27, p = 0.0006) at onset. Finally, patients with lupus nephritis required more hospitalizations (> 1) over the course of disease (89% vs 60%, OR = 7.8, 95% CI: 2.1-29, p = 0.002). In conclusion, lupus nephritis appears early during the course of SLE. Malar erythema, oral ulcers, hypertension and hyperlipidemia at onset of disease are associated factors. Lupus nephritis is a major risk factor leading to repeated hospitalizations. This study may help to assist in public health policies in our population in order to improve patient outcomes while simultaneously reducing disease costs.

Carcinoma de células claras renales metastásico a mama / Clear cell renal carcinoma metastatic to the breast

Introducción. La metástasis a mama de una neoplasia de origen extramamario, es una entidad infrecuente, que representael 0,2 al 1,3 % de los tumores malignos no hematológicos en mama reportado en series de casos. En el 88,2 % de los casos se trata de pacientes con historia de un tumor primario previamente tratado y un 11,8% a tumor primario oculto. Los principales orígenes primarios de estas metástasis son el melanoma cutáneo y los carcinomas de origen pulmonar y ginecológico. Caso clínico. Se expone el caso de una mujer de 59 años de edad, con antecedente de carcinoma de células claras del riñón, sometida a nefrectomía radical izquierda en 2008, quien presentó lesión mamaria palpable en mama derecha, evidenciándose un nódulo hipoecoico de 6,8 x 3,5 mm en el cuadrante superior externo, cuyo estudio histopatológico mostró una lesión metastásica de origen primario renal. Discusión. En la literatura se han descrito aproximadamente 25 casos de metástasis de carcinoma de células claras del riñón a la mama, constituyéndose este en un caso excepcional y un reto diagnóstico para el patólogo y para el equipo tratante

Introduction: The presence of breast metastasis from a neoplasm of extramammary origin is an infrequent entity, representing 0.2 to 1.3 % of the non-hematological malignant tumors in breast reported in series of cases; 88.2 % are patients with history of a previously treated primary tumor, and 11.8 % are cases with a hidden primary tumor. The main primary origins of these metastases are cutaneous melanoma, and carcinomas of pulmonary and gynecological origin. Clinical case: We present the clinical case of a 59-year-old woman with a history of clear cell carcinoma of the kidney undergoing left radical nephrectomy in 2008, with a palpable breast lesion in the right breast, evidencing a hypoechoic nodule measuring 6.8 x 3.5 mm in the external upper quadrant, whose histopathological study showed a metastatic lesion of primary renal origin. Discussion: Approximately 25 cases of metastasis of clear cell carcinoma of the kidney to the breast have been described in the literature, constituting ours an exceptional case, and a diagnostic challenge for the pathologist and the treating team

La rugoscopia palatina forense como método de identificación humana a traves del análisis comparativo / Rugoscopia palatina as the Forensic Identification Method of Human through the comparative analysis

Introducción. La Identificación es el método o sistema empleado para fijar de la manera más segura la identidad de una persona en la vida jurídica, tanto civil como penal y evitar confundirla con otra. La Rugoscopia es una técnica de identificación odonto-estomatológica que se preocupa por estudiar, clasificar y registrar las rugosidades palatinas. Objetivo. Proporcionar elementos de juicio para la identificación de personas vivas o muertas a través de estructuras anatómicas específicas dentro de la cavidad oral. Pacientes y Metódos. Para la recolección de datos se realizó la toma de impresión del maxilar, en veinte pacientes atendidos en la clínica de la Carrera de Odontología de la Universidad Nacional Autonoma de Honduras en el Valle de Sula (UNAH-VS), luego se procedió a la Calcorugoscopia. El duplicado obtenido se dividió por la línea media y se registraron las formas y números de formas palatinas de cada lado. El paso siguiente fue el llenado de ficha de cada uno de los modelos pertenecientes a los individuos. Resultados. De los 20 pacientes estudiados la forma más común encontrada en el paladar derecho es las curva (24 rugas), en el paladar izquierdo fue la recta (27 rugas). Conclusiones. Las Rugas Palatinas son diferentes de un indivi-duo a otro, en una misma persona ambas mitades del paladar son diferentes. La Calcorusgoscopia es un método de identificación que no permite la presunción...AU)

Consenso médico de biopsia por aspiración con aguja fina de tiroides. reporte de citología tiroidea basado en el sistema de bethesda / Medical consensus of fine-needle aspiration biopsy of the thyroid. bethesda system for reporting thyroid cytopathology

En este artículo se presenta un consenso médico basado en el sistema de Bethesda del Instituto Nacionalde Cáncer (Estados Unidos) para el uso de la biopsia por aspiración con aguja fina en el manejo de nódulos tiroideos, realizado en conjunto con patólogos, radiólogos, endocrinólogos y otras especialidades médicas de Colombia, España, Chile, Venezuela, Estados Unidos y Panamá. En este trabajo se describen las indicaciones de la biopsia por aspiración con aguja fina de tiroides, requisitos previos, entrenamiento, acreditación, técnicas, terminología diagnóstica, pruebas complementarias y opciones de tratamiento. El objetivo del actual artículo es presentar ante la comunidad médica la clasificación de los reportes citológicos, el reporte de ecografía que propone usar el sistema de datos y el reporte de imágenes tiroideas (TIRADS, del inglés The Thyroid Imaging Reporting and Data System), el uso de la medición de tiroglobulina en biopsia por aspiración con aguja fina y técnicas de citología líquida;...

This article presents a medical consensus based on the Bethesda system of the National Cancer Institute (USA) for the use of fine needle aspiration biopsy in the management of thyroid nodules. This consensus was performed in conjunction with pathologists, radiologists, endocrinologists, and other medical specialties of Colombia, Spain, Chile, Venezuela, United States, and Panama. In this work was described the indications for fine needle aspiration biopsy of thyroid, prerequisites, training, accreditation, techniques, diagnostic terminology, additional tests and treatment options. The aim of this article is present to the medical community the classification of cytological report, ultrasound report using the data system, and the thyroid imaging reporting and data system (TIRADS); as well as, the use of thyroglobulin measurement in fine needle aspiration biopsy, and liquid-based cytology techniques...

Cáncer mamario en hombres / Mammary cancer in men

El cáncer mamario en hombres es una enfermedad infrecuente, ya que representa el 1 % de todos los cánceres de mama y es responsable del 0,1 % de las muertes por cáncer en hombres. La incidencia se ha incrementado en los últimos 25 años. En la patogenia se han involucrado factores de riesgo genéticos, hormonales y ambientales. La presentación clínica es la de una masa indolora, retroareolar, con inversión del pezón o sin ella. La enfermedad en estadios avanzados (III-IV) ocurre en más del 40 % de los pacientes. En la mayoría de los casos el diagnóstico se basa en la evaluación clínica, la mamografía, la ecografía y la biopsia. Cerca de 90 % de todos los tumores son carcinomas ductales invasores, que expresan altos niveles de receptores hormonales. El tratamiento local y regional incluye cirugía y radioterapia, dependiendo de la presentación clínica, y el tratamiento sistémico, hormonal o quimioterapia, acorde con los hallazgos clínicos y biológicos. En este artículo se presenta el caso de un paciente con la enfermedad y la última información sobre el tema.

Male breast cancer is an infrequent disease representing only about 1% of all breast cancers responsible for 0.1 % cancer deaths in men. The incidence has increased over the past 25 years. Genetic, hormonal, and environmental risk factors have been implicated in its pathogenesis. Clinical presentation is a painless retroareolar lump, or nipple inversion with more than 40% of individuals having stage III or IV disease. In most cases diagnosis is established by clinical assessment, mammography, ultrasonography and core biopsy. About 90% of all tumors are invasive ductal carcinomas, expressing high levels of hormone receptors. Locoregional treatment includes surgery and radiotherapy, according to the clinical presentation, and systemic treatment (hormonal and/or chemotherapy) according to clinical and biological features. In this article we present the case of a patient with the disease and review the latest information on this subject.

Experiencia de la técnica del ganglio centinela en la cirugía del cáncer de mama, Medellín, Colombia, 2009 / Experience with the sentinel node technique in breast cancer in Medellín, Colombia

Introducción. El cáncer de mama es el segundo cáncer más común y una importante causa de muerte entre las mujeres. Uno de los pilares para su tratamiento es la determinación del estadio de los ganglios axilares mediante el vaciamiento axilar completo. Este procedimiento conlleva gran morbilidad, la cual ha disminuido considerablemente con la implementación de la técnica del ganglio centinela. Objetivo. Describir los resultados obtenidos con la técnica del ganglio centinela en la cirugía de cáncer de mama en un centro especializado en patología de mama de Medellín. Metodología. Se llevó a cabo un estudio descriptivo, retrospectivo. Se revisaron las historias clínicas de 164 pacientes con cáncer de mama en estadio temprano. Se creó una base de datos en Microsoft Office Excel®, y se procesó con el programa estadístico SPSS®, versión 13. Resultados. El 86% de las pacientes tenía ganglio centinela negativo en la impronta y 82,3% en la patología final. El 4,3% fueron falsos negativos, y 3,5% correspondió a micrometástasis. No hubo falsos positivos. El 17% requirió vaciamiento axilar; de éstos, 78% no presentó evidencia patológica de compromiso residual. El informe más común de histología fue carcinoma ductal con infiltración, el cual, también, presentó el mayor porcentaje de ganglio centinela positivo (78,3%). De los ganglios centinela positivos en la patología final, 90% presentaron tumores positivos para receptores de estrógenos y de progesterona. Conclusión. La técnica del ganglio centinela es una buena alternativa para el manejo de cáncer temprano de mama, ya que evita intervenciones quirúrgicas que conllevan a mayor morbimortalidad de las pacientes. Con el resultado negativo se puede afirmar con bastante certeza que no hay otros ganglios afectados.

Breast cancer is the second most common cancer and an important cause of mortality in the female population. A key component of breast cancer therapy is the staging of regional lymph nodes via complete axillary lymph node dissection, which carries substantial morbidity. Nevertheless morbidity has significantly been reduced by implementing the technique of the sentinel lymph node biopsy. Objective: Description of results obtained with the technique of sentinel lymph node biopsy in breast cancer surgery in a breast pathology center in Medellín, Colombia. Methods: Retrospective study in which the medical records of 164 patients with early stage breast cancer were review and placed in a data base on Microsoft Office Excel® and statistically analyzed with the program SPSS 13®. Results: 86% of patients were sentinel lymph node negative on imprint and 82.3% on final pathology; 4.3% were false negative (3.5% due to micro-metastasis) and no false positive results were found. 17% of patients required complete axillary lymph node dissection of which 78% had no evidence of disease on final pathology. The most frequently found histological type was the Infiltrating ductal carcinoma, which also had the most sentinel lymph node positive pathology results (78.3%). 90% of patients with positive sentinel lymph nodes were also positive for estrogen and progesterone receptors. Conclusion: sentinel lymph node biopsy is a good alternative for the management of early staged breast cancer given that it prevents patients from invasive surgery that carries substantial morbidity and mortality. A negative sentinel lymph node gives the physician security that there aren’t other lymph nodes involved.

Tuberculosis in patientes treated with tumor necrosis factor-alpha antagonists living in an endemic area. Is the risk worthwhile? / Tuberculosis en pacientes tratados con antagonistas del factor de necrosis tumoral alfa en un área endémica, ¿vale la pena el riesgo?

Tumor necrosis factor alpha antagonists (TNFA) are biological agents to treat chronic inflammatory and autoimmune diseases. However, their use is associated with an increased rate of tuberculosis, endemic mycoses, and intracellular bacterial infections. Since tuberculosis is moderately to highly endemic in Colombia, the risk of these infections in patients treated with TNFAs may be higher than previously reported in Colombia. Recently, four patients have developed tuberculosis during TNFA therapy. Tuberculosis appeared between 3 to 24 months after initiation of TFNA therapy and was independent of previous tuberculin skin test status. A review of the relevant literature and recommendations are presented as guides for surveillance and prophylaxis on a country-wide basis.

Los antagonistas del factor de necrosis tumoral alfa (infliximab, adalimumab y etanercept) son agentes biológicos utilizados en el tratamiento de enfermedades inflamatorias crónicas y autoinmunes. Sin embargo, su uso está asociado con el incremento de la tasa de tuberculosis, micosis endémicas e infecciones bacterianas intracelulares. Dado que la tuberculosis es moderada/altamente endémica en Colombia, el riesgo de esta infección en los pacientes tratados con estos agentes biológicos puede incrementarse y hacer dicha tasa mayor que la informada previamente (tanto en Colombia como en el mundo). Se presentan cuatro pacientes que desarrollaron tuberculosis durante el tratamiento con antagonistas del factor de necrosis tumoral alfa. La presentación de la tuberculosis ocurrió en promedio 15 meses después del inicio del agente biológico y fue independiente de la prueba de tuberculina. Se hace una revisión del tema y se plantea la necesidad de implementar guías y estrategias gubernamentales orientadas a la detección y profilaxis de tuberculosis en este grupo de pacientes.

El caso de infecciosas: paracoccidioidomicosis: presentacion inusal en un paciente joven / The case of infectious diseases: paracoccidioidomycosis: inusal presentation in a young patient

Se presenta el caso de un hombre de 24 años, agricultor, quien consultó al Hospital Marco Fidel Suárez de Bello por un cuadro de año y medio de evolución, consistente en la presencia de una masa en el testículo derecho y dos meses de pérdida de peso e ictericia. La ecografía y la TAC de abdomen mostraron obstrucción del árbol biliar distal, nódulos retroperitoneales e inguinales, hepatoesplenomegalia, aumento del páncreas e hidrocele bilateral. Se realizó laparotomía exploradora y se tomaron biopsias mesentéricas, que revelaron abundantes levaduras con gemación múltiple, compatible con Paracoccidioides brasiliensis. Las pruebas serológicas reforzaron este diagnóstico. Se comenzó tratamiento con itraconazol, 200 mg al día. Después de 2 meses de tratamiento, la respuesta ha sido satisfactoria. Este caso ilustra el polimorfismo de la paracoccidioidomicosis y la necesidad de considerarla en el diagnóstico diferencial de otras patologías del sistema retículo endotelial.

Nefritis lupica: definicion clinica, patologica y terapeutica / Lupus nephritis

El compromiso renal en el lupus eritematoso sistémico tiene un triple interés dado que, en primer lugar, la nefritis lúpica (NL) es frecuente, en segundo lugar, es un factor de pronóstico importante y, finalmente, tiene un interés fisiopatológico para el estudio de la enfermedad. En el presente artículo presentamos una definición clínica, patológica y terapéutica de la NL .Siguiendo la metodología propuesta para los consensos, este trabajo fue realizado mediante varias reuniones de especialistas de la Clínica Universitaria Bolivariana (CUB), en Medellín. La experiencia de cada autor fue considerada, se revisaron y escogieron las referencias pertinentes, y se redactó un documento guía para el manejo unificado de estos pacientes

Compromiso dermatologico inflamatorio en pacientes con sindrome de Sjogren / Dermatologic inflammatory compromise in patients with Sjogren syndrome

Objetivo: el compromiso dermatológico síndrome de Sjógren primario (SSp) puede ser no-inflamatorio e inflamatorio. En el presente estudio examinamos la prevalencia y características clínicas e inmunológicas del compromiso dermatológico inflamatorio en pacientes con SSp. Métodos: se incluyeron 95 pacientes seguidos durante un promedio de 4.1 ± 0.7 años. El compromiso dermatológico inflamatorio fue definido por la presencia de eritema, púrpura y/o urticaria. Se compararon las características de los pacientes con compromiso dermatológico y sin éste.Resultados: veinte (21 por ciento) pacientes presentaron compromiso dermatológico inflamatorio. La edad de inicio de la enfermedad fue más temprana que en aquéllos sin compromiso dermatológico (38± 3 años vs. 44± 1.6 años, p=0.05), y se presentó tempranamente durante el curso del SSp. Las lesiones más observadas fueron púrpura (35 por ciento) y urticaria vasculítica (30 por ciento). En 12 casos se practicó biopsia de piel, observándose en 10 (83 por ciento) una vasculitis leucocitoclástica, una vasculitis linfocítica y una vasculitis nodular. De 16 pacientes actualmente en seguimiento, 12 (75 por ciento) presentan mejoría completa o parcial y 3 (2 por ciento) remisiones y recaídas. Un paciente con púrpura hipergamaglobulinémica falleció. Conclusión: el compromiso dermatológico inflamatorio en el SSp es frecuente, se observa en pacientes jóvenes y tempranamente durante el curso de la enfermedad; sigue un curso variable y su pronóstico es favorable en la mayoría de los casos.

Clinical an immunological factors associated with lupus nephritis in patients from northwestern Colombia / Factores clínicos y epidemiológicos asociados con nefritis lúpica en pacientes del noroccidente colombiano

A cross-sectional and multicenter study was undertaken to analyze the clinical and immunological characteristics at diagnosis associated with nephritis in northwestern Colombian patients with systemic lupus erythematosus (SLE). Thirty nine patients with lupus nephritis were included and were compared to 100 SLE patients without nephritis. A multivariate analysis was performed. The patients who developed nephritis had a higher frequency of oral ulcers (41 percent vs. 21 percent, OR3.1, 95 percent CI: 1.3-7.5 p 0.01) and malar erythema (77 percent vs. 45 percent, OR4.4, 95 percent CI: 1.8-10.8 p0.001). Lupus nephritis was observed in 77 percent of cases during the first year of the disease. The frequency of anti-DNA antibodies was higher in patients with nephritis, however, differences were not statistically significant (83 percent vs 64 percent, OR2.6, 95 percent CI: 1.03-6.41, p0.06). The presence of other autoantibodies (anti-Ro, anti-La, anti-RNP, anti-Sm and anticardiolipin) at diagnosis was similar in both groups. This autoantibody profile remained unchanged throughout the evolution of the disease. Patients with lupus nephritis had a higher prevalence of arterial hypertension (60 percent vs 10 percent, OR13.7, 95 percent IC: 5-37, 0.00001) and hyperlipidemia (30 percent vs 7 percent, OR8.1, 95 percent IC: 2.5-27, p0.0006) at onset. Finally, patients with lupus nephritis required more hospitalizations (1) over the course of disease (89 percent vs 60 percent, OR7.8, 95 percent IC: 2.1-29, p0.002). In conclusion, lupus nephritis appears early during the course of SLE. Malar erythema, oral ulcers, hypertension and hyperlipidemia at onset of disease are associated factors. Lupus nephritis is a major risk factor leading to repeated hospitalizations. This study may help to assist in public health policies in our population in order to improve patient outcomes while simultaneously reducing disease costs.