Low complements and high titre of anti-Sm antibody as predictors of histopathologically proven silent lupus nephritis without abnormal urinalysis in patients with systemic lupus erythematosus

Jun Ishizaki, Kazuyoshi Saito, Masao Nawata, Yasushi Mizuno, Mikiko Tokunaga, Norifumi Sawamukai, Masahito Tamura, Shintaro Hirata, Kunihiro Yamaoka, Hitoshi Hasegawa, Yoshiya Tanaka

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective. The aim of this study was to clarify the clinical characteristics and predictors of silent LN (SLN), a type of LN in SLE without abnormal urinalysis or renal impairment. Methods. Of 182 patients who underwent renal biopsy, 48 did not present with abnormal urinalysis or renal impairment at the time of biopsy. The patients with LN (SLN group, n = 36) and those without LN (non-LN group, n = 12) were compared with respect to their baseline characteristics. Bivariate analysis comprised Fisher's exact test and the Mann-Whitney test, whereas multivariate analysis employed binomial logistic regression analysis. Results. LN was histopathologically identified in 36 of 48 patients. According to the International Society of Nephrology/Renal Pathology Society classification, 72% of the SLN patients were classified as having class I/II, with a further 17% having class III/IV. Bivariate analyses indicated that platelet count, serum albumin, complement components (C3 and C4), complement haemolytic activity (CH50), anti-Sm antibody titre and anti-ribonucleoprotein antibody titre were significantly different between groups. Multivariate analysis indicated that CH50 and C3 titres were significantly lower in the SLN group, whereas anti-Sm antibody titre was significantly higher. The cut-offtitre, calculated based on the receiver operating characteristic curve for CH50, was 33 U/ml, with a sensitivity and specificity of 89% and 83%, respectively. The cut-offtitre for anti-Sm antibodies was 9 U/ml, with a sensitivity and specificity of 74% and 83%, respectively. Conclusion. Low titres of CH50 and C3 and a high titre of anti-Sm antibody were identified as predictors of SLN.

Original languageEnglish
Pages (from-to)405-412
Number of pages8
JournalRheumatology (United Kingdom)
Volume54
Issue number3
DOIs
Publication statusPublished - 2015
Externally publishedYes

Fingerprint

Lupus Nephritis
Urinalysis
Systemic Lupus Erythematosus
Anti-Idiotypic Antibodies
Kidney
Multivariate Analysis
Complement C4
Biopsy
Sensitivity and Specificity
Complement C3
Ribonucleoproteins
Platelet Count
Serum Albumin
ROC Curve
Complement System Proteins
Logistic Models
Regression Analysis
Pathology

Keywords

  • Anti-Sm antibody
  • Complement
  • Silent lupus nephritis
  • systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

Low complements and high titre of anti-Sm antibody as predictors of histopathologically proven silent lupus nephritis without abnormal urinalysis in patients with systemic lupus erythematosus. / Ishizaki, Jun; Saito, Kazuyoshi; Nawata, Masao; Mizuno, Yasushi; Tokunaga, Mikiko; Sawamukai, Norifumi; Tamura, Masahito; Hirata, Shintaro; Yamaoka, Kunihiro; Hasegawa, Hitoshi; Tanaka, Yoshiya.

In: Rheumatology (United Kingdom), Vol. 54, No. 3, 2015, p. 405-412.

Research output: Contribution to journalArticle

Ishizaki, Jun ; Saito, Kazuyoshi ; Nawata, Masao ; Mizuno, Yasushi ; Tokunaga, Mikiko ; Sawamukai, Norifumi ; Tamura, Masahito ; Hirata, Shintaro ; Yamaoka, Kunihiro ; Hasegawa, Hitoshi ; Tanaka, Yoshiya. / Low complements and high titre of anti-Sm antibody as predictors of histopathologically proven silent lupus nephritis without abnormal urinalysis in patients with systemic lupus erythematosus. In: Rheumatology (United Kingdom). 2015 ; Vol. 54, No. 3. pp. 405-412.
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abstract = "Objective. The aim of this study was to clarify the clinical characteristics and predictors of silent LN (SLN), a type of LN in SLE without abnormal urinalysis or renal impairment. Methods. Of 182 patients who underwent renal biopsy, 48 did not present with abnormal urinalysis or renal impairment at the time of biopsy. The patients with LN (SLN group, n = 36) and those without LN (non-LN group, n = 12) were compared with respect to their baseline characteristics. Bivariate analysis comprised Fisher's exact test and the Mann-Whitney test, whereas multivariate analysis employed binomial logistic regression analysis. Results. LN was histopathologically identified in 36 of 48 patients. According to the International Society of Nephrology/Renal Pathology Society classification, 72{\%} of the SLN patients were classified as having class I/II, with a further 17{\%} having class III/IV. Bivariate analyses indicated that platelet count, serum albumin, complement components (C3 and C4), complement haemolytic activity (CH50), anti-Sm antibody titre and anti-ribonucleoprotein antibody titre were significantly different between groups. Multivariate analysis indicated that CH50 and C3 titres were significantly lower in the SLN group, whereas anti-Sm antibody titre was significantly higher. The cut-offtitre, calculated based on the receiver operating characteristic curve for CH50, was 33 U/ml, with a sensitivity and specificity of 89{\%} and 83{\%}, respectively. The cut-offtitre for anti-Sm antibodies was 9 U/ml, with a sensitivity and specificity of 74{\%} and 83{\%}, respectively. Conclusion. Low titres of CH50 and C3 and a high titre of anti-Sm antibody were identified as predictors of SLN.",
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author = "Jun Ishizaki and Kazuyoshi Saito and Masao Nawata and Yasushi Mizuno and Mikiko Tokunaga and Norifumi Sawamukai and Masahito Tamura and Shintaro Hirata and Kunihiro Yamaoka and Hitoshi Hasegawa and Yoshiya Tanaka",
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T1 - Low complements and high titre of anti-Sm antibody as predictors of histopathologically proven silent lupus nephritis without abnormal urinalysis in patients with systemic lupus erythematosus

AU - Ishizaki, Jun

AU - Saito, Kazuyoshi

AU - Nawata, Masao

AU - Mizuno, Yasushi

AU - Tokunaga, Mikiko

AU - Sawamukai, Norifumi

AU - Tamura, Masahito

AU - Hirata, Shintaro

AU - Yamaoka, Kunihiro

AU - Hasegawa, Hitoshi

AU - Tanaka, Yoshiya

PY - 2015

Y1 - 2015

N2 - Objective. The aim of this study was to clarify the clinical characteristics and predictors of silent LN (SLN), a type of LN in SLE without abnormal urinalysis or renal impairment. Methods. Of 182 patients who underwent renal biopsy, 48 did not present with abnormal urinalysis or renal impairment at the time of biopsy. The patients with LN (SLN group, n = 36) and those without LN (non-LN group, n = 12) were compared with respect to their baseline characteristics. Bivariate analysis comprised Fisher's exact test and the Mann-Whitney test, whereas multivariate analysis employed binomial logistic regression analysis. Results. LN was histopathologically identified in 36 of 48 patients. According to the International Society of Nephrology/Renal Pathology Society classification, 72% of the SLN patients were classified as having class I/II, with a further 17% having class III/IV. Bivariate analyses indicated that platelet count, serum albumin, complement components (C3 and C4), complement haemolytic activity (CH50), anti-Sm antibody titre and anti-ribonucleoprotein antibody titre were significantly different between groups. Multivariate analysis indicated that CH50 and C3 titres were significantly lower in the SLN group, whereas anti-Sm antibody titre was significantly higher. The cut-offtitre, calculated based on the receiver operating characteristic curve for CH50, was 33 U/ml, with a sensitivity and specificity of 89% and 83%, respectively. The cut-offtitre for anti-Sm antibodies was 9 U/ml, with a sensitivity and specificity of 74% and 83%, respectively. Conclusion. Low titres of CH50 and C3 and a high titre of anti-Sm antibody were identified as predictors of SLN.

AB - Objective. The aim of this study was to clarify the clinical characteristics and predictors of silent LN (SLN), a type of LN in SLE without abnormal urinalysis or renal impairment. Methods. Of 182 patients who underwent renal biopsy, 48 did not present with abnormal urinalysis or renal impairment at the time of biopsy. The patients with LN (SLN group, n = 36) and those without LN (non-LN group, n = 12) were compared with respect to their baseline characteristics. Bivariate analysis comprised Fisher's exact test and the Mann-Whitney test, whereas multivariate analysis employed binomial logistic regression analysis. Results. LN was histopathologically identified in 36 of 48 patients. According to the International Society of Nephrology/Renal Pathology Society classification, 72% of the SLN patients were classified as having class I/II, with a further 17% having class III/IV. Bivariate analyses indicated that platelet count, serum albumin, complement components (C3 and C4), complement haemolytic activity (CH50), anti-Sm antibody titre and anti-ribonucleoprotein antibody titre were significantly different between groups. Multivariate analysis indicated that CH50 and C3 titres were significantly lower in the SLN group, whereas anti-Sm antibody titre was significantly higher. The cut-offtitre, calculated based on the receiver operating characteristic curve for CH50, was 33 U/ml, with a sensitivity and specificity of 89% and 83%, respectively. The cut-offtitre for anti-Sm antibodies was 9 U/ml, with a sensitivity and specificity of 74% and 83%, respectively. Conclusion. Low titres of CH50 and C3 and a high titre of anti-Sm antibody were identified as predictors of SLN.

KW - Anti-Sm antibody

KW - Complement

KW - Silent lupus nephritis

KW - systemic lupus erythematosus

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U2 - 10.1093/rheumatology/keu343

DO - 10.1093/rheumatology/keu343

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JO - Rheumatology (United Kingdom)

JF - Rheumatology (United Kingdom)

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