A study to evaluate the correlation between serological profile and histopathology of lupus nephritis
Journal Title: International Archives of Integrated Medicine - Year 2019, Vol 6, Issue 4
Abstract
Background: Systemic lupus erythematosus is an autoimmune disease of unknown etiology, characterized by the involvement of multiple organ systems. Organ damage is mediated by tissue binding autoantibodies and immune complexes. High anti-dsDNA titer and low serum complement levels (C3, C4) correlate with disease activity of SLE, especially with lupus nephritis (LN). Aim of the study: To evaluate the correlation between a serological profile (anti-dsDNA, serum C3, and C4) and histopathology of lupus nephritis and to find out the class of LN which has a significant correlation with the serological profile. Materials and methods: This retrospective study was conducted in the Department of Nephrology, Kilpauk Medical College and Hospital, Chennai between 2013-2017 with 50 ANA positive female SLE patients with evidence of lupus nephritis (proteinuria, microscopic hematuria or increased serum creatinine). Serological profile (anti-dsDNA, serum C3, and C4) and renal biopsy were done in all patients. Results: Of 50 patients, 35 (70%) had class IV lupus nephritis, 7 (14%) class II, 4(8%) class V and 4 patients (8%) had class IV and V on renal biopsy. The prevalence of anti dsDNA was 97.1% in LN and 97.4% (38 of 39 pts) in proliferative LN (p<0.001). The C3 level was low in 68% of patients with LN and 84.6% with proliferative LN (p <0.001). C4 level was low in 74% of patients with LN and 87.2% with proliferative LN (p <0.001). In our study, 72% (28 of 39 pts) of the patients with proliferative LN (class IV, IV and V) had the combination of anti-dsDNA positivity, low C3,and low C4 levels but none of the patients with class II or class V LN had this combination of serology. Conclusion: In our study, the serological profile of SLE had a significant correlation with histopathology of lupus nephritis. Anti-dsDNA, low C3, and low C4 had a significant independent correlation (p<0.05) with proliferative LN (class IV, IV and V).
Authors and Affiliations
Vasudevan Chelliah, Ramesh Subramanian
Keywords
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