title: Analysis of 15 patients with systemic lupus erythematosus manifesting with negative immunofluorescence anti-nuclear antibodies after treatment.
abstract: The purpose of this study was to investigate the clinical and laboratorial characteristics of patients with systemic lupus erythematosus (SLE) manifesting with negative immunofluorescence anti-nuclear antibodies (IFANA) after treatment for the better understanding of negative conversion of IFANA. Demographic characteristics, clinical and laboratory data of hospitalized SLE patients between March 2006 and May 2011 were retrospectively reviewed. Fifteen cases with negative IFANA were identified in 960 patients. All of the 15 patients were severe, 11 patients manifested with nephritic range proteinuria and hypoalbuminemia, 8 patients were complicated with severe infection and all of the patients had been treated with glucocorticoid and immunosuppressant. Anti-ENA antibodies were positive in 4 of 15 patients. Eight patients died after average 1-year follow-up. Collectively, negative IFANA is mainly attributed to nephritic-range proteinuria; and large-dose glucocorticoid, immunosuppressant and severe infection are also important factors for negative IFANA. Antinuclear antibody can be detected in some SLE patients with negative IFANA by changing the detection method and titer. Negative conversion of IFANA often indicates unfavorable prognosis for severe patients.
authors.affiliation: Department of Rheumatology, Qilu Hospital of Shandong University, Jinan, P.R. China.
authors.forename: L-J
authors.initials: LJ
authors.lastname: Song
authors.forename: F
authors.initials: F
authors.lastname: Ding
authors.forename: H-X
authors.initials: HX
authors.lastname: Liu
authors.forename: Q
authors.initials: Q
authors.lastname: Shu
authors.forename: X
authors.initials: X
authors.lastname: Yu
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: X-F
authors.initials: XF
authors.lastname: Li
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D034961:Antigens, Nuclear / Q000276:immunology; D001324:Autoantigens / Q000276:immunology*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D003176:Complement C3 / Q000378:metabolism; D003181:Complement C4 / Q000378:metabolism; D005260:Female; D005455:Fluorescent Antibody Technique; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D034141:Hypoalbuminemia / Q000209:etiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000209:etiology; D012189:Retrospective Studies; D012261:Ribonucleoproteins / Q000276:immunology*; D012720:Severity of Illness Index; D055815:Young Adult; D000097585:SS-B Antigen; D000099207:SS-A Antigen
chemical_list: D000974:Antibodies, Antinuclear; D034961:Antigens, Nuclear; D001324:Autoantigens; D002097:C-Reactive Protein; D003176:Complement C3; D003181:Complement C4; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D012261:Ribonucleoproteins; D000097585:SS-B Antigen; D000099207:SS-A Antigen