Comparison of urinary parameters, biomarkers, and outcome of childhood systemic lupus erythematosus early onset-lupus nephritis
Abstract Background Urinary parameters, anti-dsDNA antibodies and complement tests were explored in patients with childhood-Systemic Lupus Erythematosus (cSLE) early-onset lupus nephritis (ELN) from a large multicenter cohort study. Methods Clinical and laboratory features of cSLE cases with kidney...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-02-01
|
| Series: | Advances in Rheumatology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42358-020-0114-4 |
| _version_ | 1818460885907144704 |
|---|---|
| author | Daniele Faria Miguel Maria Teresa Terreri Rosa Maria Rodrigues Pereira Eloisa Bonfá Clovis Artur Almeida Silva José Eduardo Corrente Claudia Saad Magalhaes for the Brazilian Childhood-onset Systemic Lupus Erythematosus Group |
| author_facet | Daniele Faria Miguel Maria Teresa Terreri Rosa Maria Rodrigues Pereira Eloisa Bonfá Clovis Artur Almeida Silva José Eduardo Corrente Claudia Saad Magalhaes for the Brazilian Childhood-onset Systemic Lupus Erythematosus Group |
| author_sort | Daniele Faria Miguel |
| collection | DOAJ |
| description | Abstract Background Urinary parameters, anti-dsDNA antibodies and complement tests were explored in patients with childhood-Systemic Lupus Erythematosus (cSLE) early-onset lupus nephritis (ELN) from a large multicenter cohort study. Methods Clinical and laboratory features of cSLE cases with kidney involvement at presentation, were reviewed. Disease activity parameters including SLEDAI-2 K scores and major organ involvement at onset and follow up, with accrued damage scored by SLICC-DI, during last follow up, were compared with those without kidney involvement. Autoantibodies, renal function and complement tests were determined by standard methods. Subjects were grouped by presence or absence of ELN. Results Out of the 846 subjects enrolled, mean age 11.6 (SD 3.6) years; 427 (50.5%) had ELN. There was no significant difference in the ELN proportion, according to onset age, but ELN frequency was significantly higher in non-Caucasians (p = 0.03). Hematuria, pyuria, urine casts, 24-h proteinuria and arterial hypertension at baseline, all had significant association with ELN outcome (p < 0.001). With a similar follow up time, there were significantly higher SLICC-DI damage scores during last follow up visit (p = 0.004) and also higher death rates (p < 0.0001) in those with ELN. Low C3 (chi-square test, p = 0.01), but not C3 levels associated significantly with ELN. High anti-dsDNA antibody levels were associated with ELN (p < 0.0001), but anti-Sm, anti-RNP, anti-Ro, anti-La antibodies were not associated. Low C4, C4 levels, low CH50 and CH50 values had no significant association. High erythrocyte sedimentation rate (ESR) was associated with the absence of ELN (p = 0.02). Conclusion The frequency of ELN was 50%, resulting in higher morbidity and mortality compared to those without ELN. The urinary parameters, positive anti-dsDNA and low C3 are reliable for discriminating ELN. |
| first_indexed | 2024-12-14T23:37:22Z |
| format | Article |
| id | doaj.art-003fced7c9044951860e82a3182ef23f |
| institution | Directory Open Access Journal |
| issn | 2523-3106 |
| language | English |
| last_indexed | 2024-12-14T23:37:22Z |
| publishDate | 2020-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Advances in Rheumatology |
| spelling | doaj.art-003fced7c9044951860e82a3182ef23f2022-12-21T22:43:35ZengBMCAdvances in Rheumatology2523-31062020-02-016011510.1186/s42358-020-0114-4Comparison of urinary parameters, biomarkers, and outcome of childhood systemic lupus erythematosus early onset-lupus nephritisDaniele Faria Miguel0Maria Teresa Terreri1Rosa Maria Rodrigues Pereira2Eloisa Bonfá3Clovis Artur Almeida Silva4José Eduardo Corrente5Claudia Saad Magalhaes6for the Brazilian Childhood-onset Systemic Lupus Erythematosus GroupUniversidade Estadual Paulista (UNESP) Faculdade de Medicina de BotucatuPediatric Rheumatology Division, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP)Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São PauloRheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São PauloChildren’s Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São PauloBiostatistic Department, Instituto de Biociencias, Universidade Estadual Paulista (UNESP)Pediatric Rheumatology Division, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP)Abstract Background Urinary parameters, anti-dsDNA antibodies and complement tests were explored in patients with childhood-Systemic Lupus Erythematosus (cSLE) early-onset lupus nephritis (ELN) from a large multicenter cohort study. Methods Clinical and laboratory features of cSLE cases with kidney involvement at presentation, were reviewed. Disease activity parameters including SLEDAI-2 K scores and major organ involvement at onset and follow up, with accrued damage scored by SLICC-DI, during last follow up, were compared with those without kidney involvement. Autoantibodies, renal function and complement tests were determined by standard methods. Subjects were grouped by presence or absence of ELN. Results Out of the 846 subjects enrolled, mean age 11.6 (SD 3.6) years; 427 (50.5%) had ELN. There was no significant difference in the ELN proportion, according to onset age, but ELN frequency was significantly higher in non-Caucasians (p = 0.03). Hematuria, pyuria, urine casts, 24-h proteinuria and arterial hypertension at baseline, all had significant association with ELN outcome (p < 0.001). With a similar follow up time, there were significantly higher SLICC-DI damage scores during last follow up visit (p = 0.004) and also higher death rates (p < 0.0001) in those with ELN. Low C3 (chi-square test, p = 0.01), but not C3 levels associated significantly with ELN. High anti-dsDNA antibody levels were associated with ELN (p < 0.0001), but anti-Sm, anti-RNP, anti-Ro, anti-La antibodies were not associated. Low C4, C4 levels, low CH50 and CH50 values had no significant association. High erythrocyte sedimentation rate (ESR) was associated with the absence of ELN (p = 0.02). Conclusion The frequency of ELN was 50%, resulting in higher morbidity and mortality compared to those without ELN. The urinary parameters, positive anti-dsDNA and low C3 are reliable for discriminating ELN.https://doi.org/10.1186/s42358-020-0114-4Anti-dsDNA antibodiesChildhood-onset systemic lupus erythematosusComplementC3C4Lupus nephritis |
| spellingShingle | Daniele Faria Miguel Maria Teresa Terreri Rosa Maria Rodrigues Pereira Eloisa Bonfá Clovis Artur Almeida Silva José Eduardo Corrente Claudia Saad Magalhaes for the Brazilian Childhood-onset Systemic Lupus Erythematosus Group Comparison of urinary parameters, biomarkers, and outcome of childhood systemic lupus erythematosus early onset-lupus nephritis Advances in Rheumatology Anti-dsDNA antibodies Childhood-onset systemic lupus erythematosus Complement C3 C4 Lupus nephritis |
| title | Comparison of urinary parameters, biomarkers, and outcome of childhood systemic lupus erythematosus early onset-lupus nephritis |
| title_full | Comparison of urinary parameters, biomarkers, and outcome of childhood systemic lupus erythematosus early onset-lupus nephritis |
| title_fullStr | Comparison of urinary parameters, biomarkers, and outcome of childhood systemic lupus erythematosus early onset-lupus nephritis |
| title_full_unstemmed | Comparison of urinary parameters, biomarkers, and outcome of childhood systemic lupus erythematosus early onset-lupus nephritis |
| title_short | Comparison of urinary parameters, biomarkers, and outcome of childhood systemic lupus erythematosus early onset-lupus nephritis |
| title_sort | comparison of urinary parameters biomarkers and outcome of childhood systemic lupus erythematosus early onset lupus nephritis |
| topic | Anti-dsDNA antibodies Childhood-onset systemic lupus erythematosus Complement C3 C4 Lupus nephritis |
| url | https://doi.org/10.1186/s42358-020-0114-4 |
| work_keys_str_mv | AT danielefariamiguel comparisonofurinaryparametersbiomarkersandoutcomeofchildhoodsystemiclupuserythematosusearlyonsetlupusnephritis AT mariateresaterreri comparisonofurinaryparametersbiomarkersandoutcomeofchildhoodsystemiclupuserythematosusearlyonsetlupusnephritis AT rosamariarodriguespereira comparisonofurinaryparametersbiomarkersandoutcomeofchildhoodsystemiclupuserythematosusearlyonsetlupusnephritis AT eloisabonfa comparisonofurinaryparametersbiomarkersandoutcomeofchildhoodsystemiclupuserythematosusearlyonsetlupusnephritis AT clovisarturalmeidasilva comparisonofurinaryparametersbiomarkersandoutcomeofchildhoodsystemiclupuserythematosusearlyonsetlupusnephritis AT joseeduardocorrente comparisonofurinaryparametersbiomarkersandoutcomeofchildhoodsystemiclupuserythematosusearlyonsetlupusnephritis AT claudiasaadmagalhaes comparisonofurinaryparametersbiomarkersandoutcomeofchildhoodsystemiclupuserythematosusearlyonsetlupusnephritis AT forthebrazilianchildhoodonsetsystemiclupuserythematosusgroup comparisonofurinaryparametersbiomarkersandoutcomeofchildhoodsystemiclupuserythematosusearlyonsetlupusnephritis |