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Cut-off values of immunological tests to identify patients at high risk of severe lupus nephritis.
- Source :
-
Medicina [Medicina (B Aires)] 2018; Vol. 78 (5), pp. 329-335. - Publication Year :
- 2018
-
Abstract
- Cut-off values for anti-dsDNA, anti-nucleosome and anti-C1q antibodies tests and for complementmediated hemolytic activity (CH50) were explored to identify patients with high risk of developing severe lupus nephritis (LN). Forty-one patients with confirmed systemic lupus erythematosus (SLE) were identified; their levels for the three antibodies and complement had been measured on a same serum sample. These patients were classified based on the presence of renal involvem ent; sixteen had active proliferative LN. With the cut-off values accepted in the laboratory for SLE diagnosis (anti-dsDNA > 100 UI/ml, anti-nucleosome > 50 U/ml or CH50 < 190 UCH50%) no significant differences were found between patients with and without LN. Anti-C1q > 40 U/ml showed a statistically significant association with LN and had 80% of specificity. Cut-off values for LN identified by Receiver Operating Characteristic curves (ROC) were higher for anti-dsDNA (> 455 IU/ml) and antinucleosome (>107 U/ml), lower for CH50 (< 150 UCH50%) and, for anti-C1q (> 41 U/ml) coincided with the cut-off values accepted for SLE. Anti-C1q > 134 U/ml had a 92% of specificity, 56% of sensibility and was associated with a fifteen-fold increased risk of LN. The simultaneous presence of anti-nucleosome > 107 U/ml and anti-C1q > 134 U/ml was associated with a 27-fold higher probability for LN. According to these results, the cut-off values used to detect SLE activity could be inadequate to identify patients at high risk of severe LN.
- Subjects :
- Adolescent
Adult
Antibodies, Antinuclear blood
Biomarkers blood
Child
Child, Preschool
Complement C1q immunology
Complement Hemolytic Activity Assay methods
Complement Hemolytic Activity Assay standards
Female
Humans
Immunologic Tests methods
Infant
Lupus Erythematosus, Systemic blood
Lupus Erythematosus, Systemic diagnosis
Lupus Erythematosus, Systemic immunology
Lupus Nephritis immunology
Male
Middle Aged
Nucleosomes immunology
Reference Standards
Retrospective Studies
Risk Assessment methods
Risk Factors
Sensitivity and Specificity
Severity of Illness Index
Young Adult
Immunologic Tests standards
Lupus Nephritis blood
Lupus Nephritis diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 0025-7680
- Volume :
- 78
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Medicina
- Publication Type :
- Academic Journal
- Accession number :
- 30285925