Objectives: To evaluate the role of immunological tests for monitoring lupus nephritis (LN) activity. Methods: C3, C4, anti-dsDNA and anti-C1q antibodies were prospectively performed over 6 years in 228 patients with LN. Results: In membranous LN only anti-C1q antibodies differentiated proteinuric flares from quiescent disease (p = 0.02). However, in this group 46% of flares occurred with a normal value of anti-CI q antibodies versus 20% in proliferative LN (p = 0.02), In patients with antipho- spholipid antibodies (APL), 33% of flares occurred with normal levels of anti-C1q antibodies versus 14.5% in patients that were APL-negative (p = 0.02). In proliferative LN, anti-CI q antibodies showed a slightly better sensitivity and specificity (80.5 and 71% respectively) than other tests for the diagnosis of renal flares. All four tests had good negative predictive value (NPV). At univariate analysis anti-C1q was the best renal flare predictor (p<0.0005). At multivariate analysis, the association of anti-C1q with C3 and C4 provided the best performance (p<0.0005, p<0.005, p<0.005 respectively). Conclusions: Anti-CIq is slightly better than the other tests to confirm the clinical activity of LN, particularly in patients with proliferative LN and in the absence of APL. All four "specific" tests had a good NPV, suggesting that, in the presence of normal values of each, active LN is unlikely.

Moroni, G., Radice, A., Giammarresi, G., Quaglini, S., Gallelli, B., Leoni, A., et al. (2009). Are laboratory tests useful for monitoring the activity of lupus nephritis? A 6-year prospective study in a cohort of 228 patients with lupus nephritis. ANNALS OF THE RHEUMATIC DISEASES, 68(2), 234-237 [10.1136/ard.2008.094508].

Are laboratory tests useful for monitoring the activity of lupus nephritis? A 6-year prospective study in a cohort of 228 patients with lupus nephritis

SINICO, RENATO ALBERTO
Ultimo
2009

Abstract

Objectives: To evaluate the role of immunological tests for monitoring lupus nephritis (LN) activity. Methods: C3, C4, anti-dsDNA and anti-C1q antibodies were prospectively performed over 6 years in 228 patients with LN. Results: In membranous LN only anti-C1q antibodies differentiated proteinuric flares from quiescent disease (p = 0.02). However, in this group 46% of flares occurred with a normal value of anti-CI q antibodies versus 20% in proliferative LN (p = 0.02), In patients with antipho- spholipid antibodies (APL), 33% of flares occurred with normal levels of anti-C1q antibodies versus 14.5% in patients that were APL-negative (p = 0.02). In proliferative LN, anti-CI q antibodies showed a slightly better sensitivity and specificity (80.5 and 71% respectively) than other tests for the diagnosis of renal flares. All four tests had good negative predictive value (NPV). At univariate analysis anti-C1q was the best renal flare predictor (p<0.0005). At multivariate analysis, the association of anti-C1q with C3 and C4 provided the best performance (p<0.0005, p<0.005, p<0.005 respectively). Conclusions: Anti-CIq is slightly better than the other tests to confirm the clinical activity of LN, particularly in patients with proliferative LN and in the absence of APL. All four "specific" tests had a good NPV, suggesting that, in the presence of normal values of each, active LN is unlikely.
Articolo in rivista - Articolo scientifico
Adult; Antibodies, Antinuclear; Autoantibodies; Biomarkers; Complement C1q; Complement C3; Complement C4; DNA; Epidemiologic Methods; Female; Humans; Lupus Nephritis; Male; Middle Aged; Severity of Illness Index; Young Adult; Rheumatology; Immunology; Biochemistry, Genetics and Molecular Biology (all); Immunology and Allergy
English
2009
68
2
234
237
none
Moroni, G., Radice, A., Giammarresi, G., Quaglini, S., Gallelli, B., Leoni, A., et al. (2009). Are laboratory tests useful for monitoring the activity of lupus nephritis? A 6-year prospective study in a cohort of 228 patients with lupus nephritis. ANNALS OF THE RHEUMATIC DISEASES, 68(2), 234-237 [10.1136/ard.2008.094508].
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/139374
Citazioni
  • Scopus 129
  • ???jsp.display-item.citation.isi??? 110
Social impact