Serological markers in Arabs with lupus nephritis

Abstract

The aim of this study was to characterize the autoantibody profile of Arabs with lupus nephritis (LN). Therefore, the records of 42 Arabs with classical systemic lupus erythematosus (SLE) were reviewed. Twenty one (50%) with LN and 21 without. Most patients with LN have developed their nephropathy within the first five years of the disease. Only C3 hypocomplementemia achieved statistically significant correlation in nephritic patients and anti ribonucleoprotein (RNP) antibodies in non-nephritic patients. The difference in anti double stranded DNA (dsDNA) antibodies was insignificant (P = 0.107), as both groups had markedly high prevalence of these antibodies. In addition, there was no significant negative association between detectable rheumatoid factor (RI) and patients with LN. We also examined the spectrum of specific entities of antibodies that had previously been reported in association with LN in other series (anti Smith (Sm), RNP and SS-A without anti SS-B, anti SS-A and SS-B, anti RNP and Smith, anti RNP and dsDNA and anti RNP and SS-A antibodies). None has shown any correlation with renal disease, P = 1.00, P = 0.591, P = 0.613, P = 0.195 and P = 0.148, respectively. In conclusion, the study demonstrates that Arab patients with LN do not exhibit a distinctive serological profile, nonetheless it provides useful information to studies of SLE in different ethnic or racial groups.

Keywords

ethnicity Arabs systemic lupus erythematosus nephritis

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References

Ballou SP , Khan MA , Kushner I . Clinical features of systemic lupus erythematosus: differences related to race and age of onset . Arthritis Rheum 1982; 25: 55–60 .

Citera G , Wilson WA . Ethnic and geographical perspectives in SLE . Lupus 1993; 2: 351–353 .

Ward MM , Studenski S . Clinical manifestations of systemic lupus erythematosus. Identification of racial and socioeconomic infiuences .Arch Inter Med 1991; 91: 343–353 .

Walker WG , Solez K . Renal involvement in disorders of connective tissue. In: Earley LE , Gottschalk CW (eds). Diseases of Kidneys. (vol. 2.) Little, Brown: Boston , 1979, pp 1259–1288.

Al Attia HM . Clinicolaboratory profile of 33 Arabs with systemic lupus erythematosus . Postgrad Med J 1996; 72: 677–679 .

Tan EM et al. The 1982 revised criteria for the classification of systemic lupus erythematosus (SLE) . Arthritis Rheum 1982; 25: 1271–1277 .

Gharavi AE , Harris EN , Asherson RA , Hughes GRV . Anticardiolipin antibodies: Isotype distribution and phospholipid specificity . Ann Rheum Dis 1987; 46: 1–6 .

Grishman E , Gerber MA , Churg J . Pattern of renal injury in systemic lupus erythematosus: Light and immunofiuorescence microscopic observations . Am J Kid Dis 2 1982; (suppl 1): 135–141 .

Cervera R et al. Systemic lupus erythematosus: Clinical and immunologic patterns of disease expression in a cohort of 1,000 patients . Medicine 1993; 72: 113–124 .

10.

Garcia CO et al. Autoantibody profile in African-American patients with lupus nephritis . Lupus 1996; 5: 602–605 .

11.

Howard TW , Iannini MJ , Burge JJ , Davis JS . Rheumatoid factor, cryoglobulinemia, anti-DNA and renal disease in patients with systemic lupus erythematosus . J Rheumatol 1991; 18: 826–830 .

12.

Grigor R , Edmonds J , Lewkonia R , Bresnihan B , Hughes GRV . Systemic lupus erythematosus: A prospective analysis . Ann Rheum Dis 1987; 37: 121–128 .

13.

Malaviya AN , Singh RR , Kumar A , De A , Kumar A , Aradhye S . Systemic lupus erythematosus in Northern India: A review of 329 cases . JAPI 1988; 36: 476–481 .

14.

Taylor HG , Stein CM . Systemic lupus erythematosus in Zimbabwe . Ann Rheum Dis 1986; 45: 645–648 .

15.

Boey ML , Peebles CL , Tsay G , Feng PH , Tan EM . Cinical and autoantibody correlations in Orientals with systemic lupus erythematosus . Ann Rheum Dis 1988; 47: 918–923 .

16.

Yokohari R , Tsunematsu T . Application to Japanese patients of the 1982 American Rheumatism Association revised criteria for the classification of systemic lupus erythematosus . Arthritis Rheum 1985; 28: 693–698 .

17.

Isenberg DA . Immunological tests in autoimmune rheumatic disease . Br J Hosp Med 1993; 50: 215–220 .

18.

Swaak AJG , Huysen V , Nossent JC , Smeenk RTJ . Antinuclear antibody profiles in relation to specific disease manifestations of systemic lupus erythematosus . Clin Rheumatol 1990; 9: 82–95 .

19.

Villarreal GM et al. Prevalence of 13 autoantibodies and 16/6 and related pathogenic idiotypes in 465 patients with systemic lupus erythematosus and their relationship with disease activity . Lupus 1997; 6: 425–435 .

20.

Bell DA , Smeenk RTJ . Clinical connections: assays and assessment . Lupus 1997; 6: 305–306 .

21.

Cochrane CG , Koffer D . Immune complex disease in experimental animals and man . Adv Immunol 1973; 16: 185–264 .

22.

Minter MF , Stollar BD , Angello V . Reassessment of the clinical significance of native DNA antibodies in systemic lupus erythematosus . Arthritis Rheum 1979; 22: 959–968 .

23.

JosephJ etal. Absenceofadistinctiveautoantibodyprofileinblackwomen with lupus nephritis . Arthritis Rheum 1994; 37: 1261–1262 (letter).

24.

Hamilton RG et al. Two Ro (SS-A) antibody responses in systemic lupus erythematosus: Correlation of HLA-DR/DQ specifities with quantitative expression of Ro (SS-A) autoantibody . Arthritis Rheum 1988; 31: 496–505 .

25.

Harley JB et al. A model of disease heterogeneity of systemic lupus erythematosus. Relationship between histocompatibility antigens, autoantibodies, and lymphopenia to renal disease . Arthritis Rheum 1989; 32: 826–836 .

26.

Wasicek CA , Reichlin M . Clinical and serological differences between systemic lupus erythematosus patients with antibodies to Ro versus patients with antibodies to Ro and La . J Clin Invest 1982; 69: 835–843 .

27.

Reichlin M , van Venrooij W . Autoantibodies to the URNP particles; relationship to clinical diagnosis and nephritis . Clin Exp Immunol 1991; 83: 286–290 .

28.

Montecucco C . Anti-RNP antibodies and their clinical significance . Br J Rheumatol 1991; 29: 322–324 .

29.

McCarty GA , Harley JB , Reichlin M . A distinctive autoantibody profile in black female patients with lupus nephritis . Arthritis Rheum 1993; 36: 1560–1565 .

30.

Reichlin M , Mattioli M . Correlation of a precipitin reaction to an RNA protein antigen and a low prevalence of nephritis in patients with systemic lupus erythematosus . N Eng J Med 1972; 86: 908–911 .