Clinical significance of anti-glomerular basement membrane antibodies in a cohort of Chinese patients with lupus nephritis.
OBJECTIVE
To evaluate the clinical and laboratory features of patients with lupus nephritis (LN) in the presence and absence of anti-glomerular basement membrane antibodies (anti-GBM) and to establish whether the characteristics of the disease correlate with anti-GBM.


METHODS
We performed a retrospective study of 157 hospitalised patients with systemic lupus erythematosus (SLE), 91 of whom had LN. The test for anti-GBM used an enzyme-linked immunosorbent assay (ELISA). Clinical and laboratory data were collected and assessed in LN patients with and without anti-GBM.


RESULTS
Anti-GBM was detected in 14 (8.9%) of 157 patients with SLE. All of the 14 patients developed LN; of these, 10 reached the criteria for crescentic glomerulonephritis (CGN) and five were diagnosed as Goodpasture's disease. Serum anti-GBM levels were correlated with the presence of both anti-double-stranded DNA antibodies (anti-dsDNA) and anti-nucleosome antibodies (anti-NuA). Significant differences in extrarenal clinical manifestations were found between anti-GBM-positive and -negative LN patients, with regard to pleuritis, pulmonary haemorrhage, sinusitis, and anaemia in particular.


CONCLUSIONS
LN with anti-GBM is not rare in Chinese patients. Anti-GBM, together with the additional nephritogenic potential of anti-dsDNA and anti-NuA, may play an essential role in the pathogenesis of the anti-GBM disease in LN. Therefore, in addition to routine anti-GBM assay, anti-dsDNA and anti-NuA measurements should be performed early to ensure a prompt diagnosis and immediate treatment in patients with anti-GBM-mediated disease.
Li
C-H
CH
College of Pharmacology, Zhengzhou University, Zhengzhou, P.R. China.
Li
Y-C
YC
Xu
P-S
PS
Hu
X
X
Wang
C-Y
CY
Zou
G-L
GL
D000328:Adult; D000906:Antibodies / Q000097:blood*; D044466:Asian People; D001323:Autoantibodies; D004247:DNA / Q000276:immunology; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D008181:Lupus Nephritis / Q000276:immunology* / Q000473:pathology / Q000628:therapy; D008297:Male; D009707:Nucleosomes / Q000276:immunology; D012074:Remission Induction; D012189:Retrospective Studies
D000906:Antibodies; D001323:Autoantibodies; D009707:Nucleosomes; C051951:antiglomerular basement membrane antibody; D004247:DNA