Association of antiphospholipid antibodies with clinical activity and renal pathological activity in patients with lupus nephritis

Lupus. 2021 Jun;30(7):1140-1145. doi: 10.1177/09612033211006781. Epub 2021 Apr 8.

Abstract

Objectives: This study aimed to investigate the association of antiphospholipid antibodies (aPL) with clinical activity and renal pathological activity in patients with lupus nephritis (LN).

Methods: Levels of anticardiolipin () antibodies, anti-β2-glycoprotein I (anti-β2-GPI) antibodies and lupus anticoagulant (LAC) were measured, and other clinical and pathological data were also obtained during the same period before renal biopsy.

Results: A total of 83 patients with LN were included in this study, 40 patients (48.2%) in the s positive group and 43 patients in the aPL negative group. LN patients with positive aPL had significantly higher SLEDAI (p = 0.012), more hematuria (p = 0.043), lower serum C3 (p = 0.003) and C4 (p = 0.014), and a higher pathological activity index (p = 0.012), more micro-thrombosis (p = 0.046) and more C3 deposits (p = 0.038) in the glomerulus than patients with negative aPL The level of IgG- was significantly correlated with SLEDAI and serum level of C3 (r = 0.44, p < 0.001; r = -0.39, p = 0.003, respectively). The level of IgM- was significantly correlated with SLEDAI, and serum levels of C3 and C4 (r = 0.27, p = 0.014; r = -0.22, p = 0.041; r = -0.23, p = 0.035, respectively).

Conclusions: Our work suggests that aPL, especially, are correlated with both clinical activity and renal pathological activity in patients with LN.

Keywords: Lupus nephritis (LN); anticardiolipin antibodies; antiphospholipid antibodies (aPL); disease activity.

MeSH terms

  • Adult
  • Antibodies, Anticardiolipin / blood*
  • Antibodies, Antiphospholipid / blood*
  • Antiphospholipid Syndrome / complications
  • Antiphospholipid Syndrome / diagnosis
  • Antiphospholipid Syndrome / immunology
  • Biopsy
  • Case-Control Studies
  • China / epidemiology
  • Complement Activation / immunology
  • Female
  • Hematuria / epidemiology
  • Hematuria / etiology
  • Humans
  • Immunoglobulin G / blood
  • Kidney / pathology*
  • Kidney Glomerulus / immunology
  • Kidney Glomerulus / pathology
  • Lupus Coagulation Inhibitor / blood*
  • Lupus Nephritis / immunology*
  • Lupus Nephritis / pathology
  • Lupus Nephritis / physiopathology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index
  • Thrombotic Microangiopathies / epidemiology
  • Thrombotic Microangiopathies / etiology

Substances

  • Antibodies, Anticardiolipin
  • Antibodies, Antiphospholipid
  • Immunoglobulin G
  • Lupus Coagulation Inhibitor
  • anti-beta 2 glycoprotein I autoantibody