Title:Antineutrophil Cytoplasmic Antibody in Lupus Nephritis: Correlation with Clinicopathological Characteristics and Disease Activity
Volume: 17
Issue: 2
Author(s): Dina Said, Nearmeen Mohammed Rashad, Nora Said Abdelrahmanc and Ghada Aboelsaud Dawaa*
Affiliation:
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig,Egypt
Keywords:
Antineutrophil cytoplasmic antibody, Anti-proteinase 3, Lupus nephritis, myeloperoxidase, clinicopathological,
Systemic lupus erythematosus.
Abstract: Background: Lupus nephritis (LN) represents 40%-50% of all systemic lupus erythematosus
(SLE) patients, and rapidly progressive glomerulonephritis is associated with significant morbidity
and mortality. Antineutrophil cytoplasmic antibody (ANCA) might be involved in the pathogenesis
of LN.
Objective: We evaluated the role of myeloperoxidase (MPO)-ANCA, proteinase 3 (PR3)-ANCA,
and anti-glomerular basement membrane autoantibodies (anti-GBM autoAb) for the diagnosis of
LN.
Methods: In this cross-sectional study, 95 SLE patients were divided into 2 subgroups: LN group
(n = 60) and non-LN group (n = 35). For further analysis, we subclassified the LN group into ANCA-
positive (n = 16) and ANCA-negative (n = 44) LN patients. The entire Non-LN group was ANCA-
negative. The SLE disease activity index (SLEDAI) was reported for each patient. Determination
of MPO-ANCA, PR3-ANCA, and anti-GBM autoAb was performed using a novel multiplex
bead-based technology in all patients. Data analyses were done using SPSS, version 20. Approval
was obtained from the institutional review board of Zagazig University (ZU-IRB#6000).
Results: Of 95 patients with SLE, 16 patients (16.84%) had ANCA-positive LN, all of which were
MPO-ANCA. There was a positive correlation between MPO-ANCA and SLEDAI, as well as with
class IV LN. Receiver operating characteristic analyses revealed that the sensitivity and specificity
of MPO-ANCA were 81.3% and 99.8%, respectively, in discriminating LN from systemic lupus
without nephritis.
Conclusion: MPO-ANCA level was significantly correlated with SLEDAI, inflammatory markers,
kidney function tests, and LN class IV.
