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
| Autor: | G, Moroni, A, Radice, G, Giammarresi, S, Quaglini, B, Gallelli, A, Leoni, M, Li Vecchi, M L, Vecchi, P, Messa, R A, Sinico |
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| Přispěvatelé: | Moroni, G, Radice, A, Giammarresi, G, Quaglini, S, Gallelli, B, Leoni, A, Vecchi, M, Messa, P, Sinico, R |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Systemic disease medicine.medical_specialty Immunology Lupus nephritis Gastroenterology Severity of Illness Index General Biochemistry Genetics and Molecular Biology Young Adult Rheumatology immune system diseases Internal medicine Immunopathology Medicine Humans Immunology and Allergy skin and connective tissue diseases Prospective cohort study Autoantibodies Univariate analysis Biochemistry Genetics and Molecular Biology (all) business.industry Complement C1q Complement C4 Biomarker Complement C3 DNA Lupus Nephriti Middle Aged medicine.disease Connective tissue disease Lupus Nephritis Autoantibodie Antibodies Antinuclear Epidemiologic Method Female business Epidemiologic Methods Biomarkers Kidney disease Human |
| Popis: | 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-C1q antibodies versus 20% in proliferative LN (p = 0.02). In patients with antiphospholipid 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-C1q 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 (pConclusions:Anti-C1q 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. |
| Databáze: | OpenAIRE |
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