The uncertain correlation of ANCAs in patients with lupus nephritis and crescents, an experience from Chinese centers.

IF 2.7 4区 医学 Q2 UROLOGY & NEPHROLOGY Journal of Nephrology Pub Date : 2024-11-01 Epub Date: 2024-10-10 DOI:10.1007/s40620-024-02085-5
Qiong Zhang, Fei Zhou, Yan Zhao, Congjuan Luo, Yankun Luo, Yun Zhou
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Abstract

Background: The precise role of anti-neutrophil cytoplasmic antibodies (ANCAs) in the pathologic course of crescentic lupus nephritis (LN) remains unclear. Our study aimed to assess whether ANCA-positive serology in patients with LN and crescents is associated with different clinicopathologic features and outcomes.

Methods: We reviewed the records of 658 patients diagnosed with LN between 2010 and 2022. Among them, 64 (9.7%) patients who had complete follow-up and clinical data were reclassified as crescentic glomerulonephritis. Of these, 11 patients with incomplete ANCA data and 7 patients with less than 10 glomeruli under light microscopy were excluded; ultimately, 46 patients were enrolled: 12 with ANCA positivity and 34 with ANCA negativity. Clinicopathological characteristics and outcomes were analysed and compared.

Results: Our data did not reveal any differences in clinical or laboratory parameters or histopathological features except for a significantly higher level of proteinuria or proportion of nephrotic syndrome (p < 0.05) at presentation before biopsy in the ANCA-negative group than in the ANCA-positive group,and a lower level of serum albumin (p < 0.05) in the ANCA-negative group than in the ANCA-positive group. No significant differences in complete remission or partial response were detected between the two groups based on the 2021 KDIGO criterion.

Conclusion: Short-term follow-up (average follow-up time of less than 3 years) did not reveal any difference in outcomes between ANCA-positive and ANCA-negative crescentic LN. However, the role of ANCAs in the pathological course of crescentic lupus nephropathy and the effect of ANCAs on long-term outcomes remain to be determined.

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狼疮性肾炎和新月体患者ANCAs的不确定相关性--来自中国中心的经验。
背景:抗中性粒细胞胞浆抗体(ANCA)在新月体狼疮性肾炎(LN)病理过程中的确切作用仍不清楚。我们的研究旨在评估LN和新月体患者的ANCA阳性血清学是否与不同的临床病理学特征和结局相关:我们回顾了 2010 年至 2022 年间 658 例确诊为 LN 患者的病历。其中,64 名(9.7%)有完整随访和临床数据的患者被重新分类为新月体肾小球肾炎。其中,11 名 ANCA 数据不完整的患者和 7 名光镜下肾小球少于 10 个的患者被排除在外;最终,46 名患者被纳入研究:最终有46名患者入选,其中12名ANCA阳性,34名ANCA阴性。对临床病理特征和结果进行了分析和比较:除了蛋白尿水平或肾病综合征比例明显升高(p)外,我们的数据未显示临床或实验室参数或组织病理学特征的任何差异:短期随访(平均随访时间少于 3 年)未发现 ANCA 阳性和 ANCA 阴性新月体 LN 的预后有任何差异。然而,ANCA在新月体狼疮肾病病理过程中的作用以及ANCA对长期预后的影响仍有待确定。
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来源期刊
Journal of Nephrology
Journal of Nephrology 医学-泌尿学与肾脏学
CiteScore
5.60
自引率
5.90%
发文量
289
审稿时长
3-8 weeks
期刊介绍: Journal of Nephrology is a bimonthly journal that considers publication of peer reviewed original manuscripts dealing with both clinical and laboratory investigations of relevance to the broad fields of Nephrology, Dialysis and Transplantation. It is the Official Journal of the Italian Society of Nephrology (SIN).
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