Further description of early clinically silent lupus nephritis.
Thirty silent lupus nephritis (SLN) patients were compared to 16 individuals bearing overt lupus nephritis (OLN). Results included: years of systemic lupus erythematosus (SLE) diagnosis were significantly earlier (4.6 +/- 2.8 years) in SLN than in OLN (7.18 +/- 3.61) (P < 0.05). Neurological compromise, hypertension, normocitic anemia and lymphopenia were significantly prevalent in OLN than in SLN (P < 0.05). Beside normal urinary sediment and renal function tests, the SLN group showed a moderate increase of both activity (AI) and chronicity (CI) renal pathology index when compared to highly increased AI and CI in OLN (P < 0.05). Seventy percent of SLN patients were ISN/RPS Classes I (6.6%) and II (63.3%) while 81% of OLN cases were Classes III, IV (37.5%) and V. IgG, IgA, IgM, lambda chain, C3 and fibrinogen immune deposits were found in 90% or over in both SLN and OLN individuals while in 60% or over, both groups also showed kappa chain, Clq and C4 deposits. While prevalence of ANA, anti-dsDNA and anti-C1q antibodies were similar in both groups, anti-histone, anti-RNP, CIC and CH50 serum levels were significantly different in OLN versus SLN (P < 0.05). We strongly suggest that indeed SLN is the earliest stage in the natural history of lupus nephritis.
Zabaleta-Lanz
M E
ME
Institute of Immunology (FOCIS Center), Central University School of Medicine, Caracas, Venezuela. zabaletm@ucv.ve
Muñoz
L E
LE
Tapanes
F J
FJ
Vargas-Arenas
R E
RE
Daboin
I
I
Barrios
Y
Y
Pinto
J A
JA
Bianco
N E
NE
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D015922:Complement C1q / Q000276:immunology; D003176:Complement C3 / Q000276:immunology; D004247:DNA / Q000276:immunology; D042241:Early Diagnosis; D005260:Female; D005340:Fibrinogen / Q000276:immunology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008181:Lupus Nephritis / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies
D001323:Autoantibodies; D003176:Complement C3; D015922:Complement C1q; D005340:Fibrinogen; D004247:DNA