Original InvestigationPathogenesis and Treatment of Kidney DiseaseAntinucleosome Antibodies as a Marker of Active Proliferative Lupus Nephritis
Section snippets
Participants
In this prospective multicenter study, all consecutive adult patients with SLE undergoing renal biopsy for suspected proliferative lupus nephritis were included.16 Patients had to fulfill at least 4 of the 11 American College of Rheumatology (ACR) criteria,17, 18 be at least 18 years old, and give written informed consent for study participation. All patients were recruited between August 1998 and October 2006 at the University Hospitals in Basel, Geneva, and Lausanne (Switzerland), Madrid
Participants and Test Results
Thirty-five of 40 patients with SLE undergoing renal biopsy had class III or IV lupus nephritis. Patient characteristics are listed in Table 1.
Antinucleosome antibodies were found in 31 of 35 patients (89%) with biopsy-proven active proliferative lupus nephritis. In the control populations, 19 of 23 patients with SLE (83%) with a history of lupus nephritis, but without clinical signs of activity at the time of sampling, and 28 of 36 patients with SLE (78%) without clinical signs of lupus
Discussion
The aim of this study is to determine the prevalence and diagnostic value of autoantibodies against nucleosomes in the diagnosis of proliferative lupus nephritis. Determination of antinucleosome antibodies at the time of the renal biopsy showing active proliferative lupus nephritis was considered to be the ideal tool to address the question because it should allow showing maximum differences in autoantibody concentrations compared with control patients with inactive SLE. In this setting, the
Acknowledgements
Support: Dr Trendelenburg is a recipient of a SCORE fellowship from the Swiss National Foundation (3232B0-107248/1 and 3200B0-107249/1) and was supported by a grant from the Novartis Foundation for Medical and Biological Research.
Financial Disclosure: None.
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Originally published online as doi:10.1053/j.ajkd.2007.10.041 on January 21, 2008.