Lupus nephritis: association between serology and renal biopsy measures.
The relationship between serologic tests and renal histologic change over time was examined in 55 patients with lupus nephritis. After a median interval of 40 months on various immunosuppressive drug regimens, C3 complement levels were improved in 78% of patients and anti-DNA levels were improved in 85%. Comparison of initial and followup renal pathology showed that the activity index of the biopsy improved in 82%, while the chronicity index worsened in 71% of patients. Normalization of C3, but not anti-DNA levels, was associated with a lowering of the activity index on repeat biopsy. Prolonged depression of serum C3 levels was associated with a trend (p = 0.066) towards worsening of the chronicity index, but the change in chronicity index showed no relationship to the duration of elevated anti-DNA. Our studies indicate that abnormal levels of C3 complement are predictive of the degree of persistently active glomerular disease, but that duration of abnormal C3 or anti-DNA are less consistent predictors of the acquisition of chronic, irreversible renal lesions.
Pillemer
S R
SR
Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892.
Austin
H A
HA
Tsokos
G C
GC
Balow
J E
JE
D000974:Antibodies, Antinuclear / Q000032:analysis; D000937:Antigen-Antibody Reactions; D001706:Biopsy; D003176:Complement C3 / Q000032:analysis; D004247:DNA / Q000276:immunology; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008181:Lupus Nephritis / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D012720:Severity of Illness Index
D000974:Antibodies, Antinuclear; D003176:Complement C3; D004247:DNA