RESEARCH - Delayed lupus nephritis

April 16, 2008

Ann Rheum Dis. Published Online First: 15 April 2008.

doi:10.1136/ard.2008.088740

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Concise Report

Delayed lupus nephritis

-Cristina Varela 1, Gerardo Quintana 2, C. Somers 3,

Rojas-Villarraga 1, Gerard Espinosa 4, -Eugenia Hincapie

1, W. ph McCune 3, Ricard Cervera 2 and - Anaya 5*

1 Corporación para Investigaciones Biológicas, Colombia

2 Hospital Clínic, Spain

3 University of Michigan, United States

4 Hospital Clinic, Spain

5 Corporación para Investigaciones Biológicas-Universidad del rio, Colombia

Abstract

Objective: To describe and analyze the clinical and immunological

characteristics of a large series of patients with delayed lupus

nephritis (LN).

Methods: This was a cross-sectional study. Patients with systemic

lupus erythematosus (SLE) who developed renal involvement five or more

years after the first manifestation(s) of the disease (delayed LN,

N=48) were compared to SLE patients in whom LN developed within five

years or less after SLE appeared (early-onset LN, N=187). A control

group, the no LN (NLN) group, consisted of long-standing SLE patients

(duration of disease > 10 years) who have never shown signs of renal

involvement (N=164).

Results: The delayed LN group was positively associated with Sjögren's

syndrome, lung involvement, and antiphospholipid syndrome as compared

with early LN. However, its renal clinical expression and

histopathological patterns were similar to those of early-onset LN.

The frequency of anti-dsDNA, anti-Sm and anti-RNP antibodies was

higher in patients with LN than in the NLN group, as was the frequency

of low complement levels. Jaccoud's arthropathy was a protective

factor for nephritis.

Conclusions: Delayed LN is not uncommon in SLE patients. The

identified risk factors might aid in its diagnosis and enhance ability

to identify patients at risk for this complication of SLE.

--

Not an MD

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