Session Title: SLE – Clinical Poster I: Epidemiology & Pathogenesis
Session Type: Poster Session (Sunday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Recent studies have shown that the simultaneous positivity of anti-double stranded DNA, -nucleosome, and -histone antibodies (3-pos) is prevalent in lupus nephritis (LN) patients compared to non-renal systemic lupus erythematosus (SLE) patients. The aim of this study was to define the clinical, biologic, histopathologic, and prognostic differences according to the simultaneous reactivity to those antibodies in Korean patients with biopsy-proven LN.
Methods: We studied 102 patients who underwent kidney biopsy prior to the start of induction treatment and who were subsequently treated with immunosuppressives and followed-up for more than 12 months. Sociodemographic, clinical, laboratory, and treatment-related data at the time of kidney biopsy and during follow-up were obtained by a review of patients’ charts. Antibodies were detected by immunoblot analysis or ELISA at the time of renal biopsy.
Results: Fifty-eight (35.4%) of the total of 102 LN patients had 3-pos. In comparison with non-3-pos patients, the patients with 3-pos showed a higher SLE Disease Activity Index-2000 score (P=0.002), lower lymphocyte level (p=0.004), higher proportion of proteinuria >3.5 g/24 hr (p=0.005), and higher positivity of urinary sediments (p=0.005) at the time of renal biopsy. In the renal histopathologic findings, the patients with 3-pos had more proliferative LN (p=0.015) and also showed more endocapillary hypercellularity, sub-endothelial hyaline deposits, fibrinoid necrosis/karyorrhexis, and cellular crescents in the disease activity index (p=0.016, p=0.045, p=0.002, and p=0.022, respectively), as well as a higher activity score (p=0.011). After a median follow-up of 83.2 months, rapid glomerular filtration rate decline was frequently observed in patients with 3-pos compared to those without (p=0.012).
Conclusion: Our findings suggest that 3-pos is related to severe LN and, furthermore, that patients with 3-pos show a rapid decline of renal function compared to those without.
To cite this abstract in AMA style:Choi S, Park D, Kang J, Xu H, Lee S. Association of Co-positivity for Anti-dsDNA, -Nucleosome, and -Histone Antibodies and Disease Activity in Patients with Lupus Nephritis: Results from the KORNET Registry [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/association-of-co-positivity-for-anti-dsdna-nucleosome-and-histone-antibodies-and-disease-activity-in-patients-with-lupus-nephritis-results-from-the-kornet-registry/. Accessed November 30, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-of-co-positivity-for-anti-dsdna-nucleosome-and-histone-antibodies-and-disease-activity-in-patients-with-lupus-nephritis-results-from-the-kornet-registry/