Anti-neutrophil Cytoplasmic Antibodies in New-onset Systemic Lupus Erythematosus and Lupus Nephritis
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Anti-neutrophil Cytoplasmic Antibodies in New-onset Systemic Lupus Erythematosus and Lupus Nephritis Hai-Feng Pan,1 Xue-Hui Fang,1 Guo-Cui Wu,4 Wen-Xian Li,1 Xue-Fei Zhao,1 Xiang-Pei Li,2 Jian-Hua Xu,3 and Dong-Qing Ye1,5
Abstract—This study aims to investigate the role of Antineutrophil cytoplasmic antibodies (ANCA) in patients with new-onset systemic lupus erythematosus (SLE). Sixty SLE patients, 28 of whom had lupus nephritis (LN), and 60 normal controls were enrolled; Serum ANCA was measured by enzyme linked immunosorbent assay (ELISA). The clinical and laboratory parameters of the patients were also recorded. Results show that twenty SLE patients were seropositive for ANCA, which was significantly higher than in normal controls. LN patients had significantly higher positive rate of ANCA than patients without nephritis. Compared with ANCA-negative patients, the ANCA-positive patients had significantly higher incidence of nerves system disorder, myocarditis, renal involvement and serositis. The positive rate of γ-globulin, anti-dsDNA and anti-Sm antibodies were significantly higher in ANCA-positive patients. Elevated IgG and ESR, decreased serum C3/C4 appeared more often in ANCA-positive patients. In addition, serum ANCA level correlated positively with disease activity. Taken together, ANCA might be used as a potential complementary parameter to differentiate LN from SLE without nephritis. In addition, ANCA may serve as a useful marker of the disease activity of SLE. KEY WORDS: ANCA; disease activity; nephritis; systemic lupus erythematosus.
More than one mechanism could contribute to the disease and that different mechanism may be responsible for different disease manifestations. One of these may be vasculitis, which is most commonly recognized in the skin but may be responsible for symptoms and findings in a number of organs. The two important mechanisms of vascular injury are direct injury to vessels and immune mediated inflammatory damage. Antineutrophil cytoplasmic autoantibodies (ANCA) are a distinct class of autoantibodies directed against cytoplasmic constituents of human neutrophils and monocytes. ANCA were first described in patients with necrotizing glomerulonephritis [1]. Up to now, ANCA have been detected in infectious, neoplastic and inflammatory disease [2, 3]. The association of ANCA with the vasculitides, including Wegener’s granulomatosis (WG) and microscopic polyangiitis, has been well described [4]. In fact, the presence of vasculitis is also a well-documented phenomenon in SLE patients. In one cohort study of SLE patients,
INTRODUCTION Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of multiple autoantibodies against a variety of nuclear antigens.
Hai-Feng Pan and Xue-Hui Fang contributed equally to this work. 1
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui 230032, People’s Republic of China 2 Department of Rheumatology, Anhui Provincial Hospital, Hefei, China 3 Department
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