Validation of the Systemic Lupus International Collaborating Clinics classification criteria in a cohort of patients with full house glomerular deposits.

Autor:	Rijnink EC; Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: E.C.Rijnink@lumc.nl., Teng YKO; Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands., Kraaij T; Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands., Dekkers OM; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands., Bruijn JA; Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands., Bajema IM; Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands.
Jazyk:	angličtina
Zdroj:	Kidney international [Kidney Int] 2018 Jan; Vol. 93 (1), pp. 214-220. Date of Electronic Publication: 2017 Sep 23.
DOI:	10.1016/j.kint.2017.07.017
Abstrakt:	In 2012, the Systemic Lupus International Collaborating Clinics (SLICC) presented a new classification for systemic lupus erythematosus (SLE). In this classification, biopsy-confirmed lupus nephritis with positive antinuclear or anti-double-stranded DNA antibodies became a stand-alone criterion. Because of the unknown diagnostic performance among patients from nephrology clinics, we aimed to test the validity of the SLICC classification, compared with the American College of Rheumatology classification, in a cohort of patients whose renal biopsies would raise the clinicopathologic suspicion of lupus nephritis. All patients with a renal biopsy showing full house glomerular deposits and clinical follow-up in our center were included and reevaluated, after which clinicians and a pathologist reached a consensus on the reference-standard clinical diagnosis of SLE. The diagnostic performance and net reclassification improvement were assessed in 149 patients, 117 of whom had clinical SLE. Compared with the American College of Rheumatology classification, the SLICC classification had better sensitivity (100 vs. 94%); although, this was at the expense of specificity (91 vs. 100%; net reclassification improvement -0.03). Excluding the stand-alone renal criterion, the specificity of the SLICC classification reached 100%, with a significant net reclassification improvement of 0.06 compared with the American College of Rheumatology classification. The SLICC classification performed well in terms of diagnostic sensitivity among patients with full house glomerular deposits; whereas, the stand-alone renal criterion had no additional value and compromised the specificity. Thus, presumed patients with lupus nephritis in nephrology clinics reflect a distinct SLE disease spectrum warranting caution when applying SLE classification criteria. (Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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