RESEARCH - Delayed lupus nephritis

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Published Online First: 15 April 2008. doi:10.1136/ard.2008.088740

ls of the Rheumatic Diseases 2008;67:1044-1046

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CONCISE REPORTS

Delayed lupus nephritis

D-C Varela 1,2, G Quintana 3, E C Somers 4, A Rojas-Villarraga 1,5, G

Espinosa 3, M-E Hincapie 1, W J McCune 4, R Cervera 3, J-M Anaya 1,5

1 Cellular Biology and Immunogenetics Unit, Corporación para

Investigaciones Biológicas, Medellín, Colombia

2 Clinical Immunology and Rheumatology Unit, Clínica Universitaria

Bolivariana, Medellín, Colombia

3 Department of Autoimmune Diseases, Hospital Clínic, Barcelona,

Catalonia, Spain

4 Department of Internal Medicine, University of Michigan, Ann Arbor,

Michigan, USA

5 School of Medicine, rio University, Bogota, Colombia

ABSTRACT

Objective: To describe and analyse the clinical and immunological

characteristics of a large series of patients with delayed lupus

nephritis (LN).

Methods: A cross-sectional study was carried out. Patients with

systemic lupus erythematosus (SLE) who developed renal involvement 5

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

48) were compared with patients with SLE in whom LN developed within 5

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

group, the no LN (NLN) group, comprised patients with longstanding SLE

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

involvement (n = 164).

Results: The group with delayed LN 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 patients with SLE. The

identified risk factors might aid in its diagnosis and enhance the

ability to identify patients at risk for this complication of SLE.

http://ard.bmj.com/cgi/content/abstract/67/7/1044?etoc

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