scholarly journals Clinical significance of anti-C1q antibodies in SLE

2015 ◽  
Vol 62 (s11) ◽  
pp. 15-20
Author(s):  
Ivana Stiborová ◽  
Vlastimil Král ◽  
Jozef Rovenský ◽  
Stanislava Blažíčková
Keyword(s):  
Lupus Erythematosus ◽  
Disease Index ◽  
High Avidity ◽  
Group Score ◽  
Renal Functions ◽  
Persistent Proteinuria ◽  
Double Stranded Dna ◽  
Significant Difference ◽  
History Of ◽  
Dsdna Antibodies

Abstract Lupus nephritis (LN) is a severe and frequent complication of systemic lupus erythematosus (SLE). Untreated cases very often lead to patients’ death; therefore, it is important to use markers sensitive and specific enough for the diagnosis and subsequent monitoring of nephritis. Autoantibodies against double-stranded DNA (anti-dsDNA) are believed to play a major role in SLE in general and so their significance in prediction and monitoring of glomerular inflammation is low. For prediction of renal flares and effective, well-timed therapy, it is required to have an appropriate marker available. In our study, we have tested sera of 85 SLE patients with or without LN. The criterion for LN determination was the degree of proteinuria (persistent proteinuria > 0.5 g/day, according to ACR criteria for LN). Disease activity was described by SLE disease index (SLEDAI) score, renal functions were stated according to British Isles Lupus Assessment Group score. There were anti-C1q, total anti-dsDNA and high-avidity anti-dsDNA detected in the patients’ sera. We did not find any significant difference in average SLEDAI value between patients with renal and non-renal organ complications. Positivity of anti-C1q was more frequent in patients with nephritis than in those without any history of renal disease (58.3 vs. 39.1%). Higher prevalence of these antibodies was evident in patients with clinically active LN than in those without renal improvement (73.1 vs. 39.1%). When comparing anti-C1q with antibodies against structures of DNA, significant differences were found in case of high avidity anti-dsDNA. Our results have confirmed the studies showing that anti-C1q antibodies could serve as a reliable serological marker of LN activity along with other laboratory tests. Detection of anti-C1q together with high avidity anti-dsDNA antibodies seems to be a good algorithm for the prediction of possible renal flares in SLE patients.

The clinical relevance of anti-dsDNA antibodies determined by the Elia™ dsDNA assay in patients with negative indirect immunofluorescence on the HEp-2 cell

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Christoph Robier ◽  
Maximiliane Haas ◽  
Franz Quehenberger
Keyword(s):  
Indirect Immunofluorescence ◽  
Lupus Erythematosus ◽  
Medical Records ◽  
Clinical Relevance ◽  
Solid Phase ◽  
Clinical Importance ◽  
Discoid Lupus Erythematosus ◽  
Combined Use ◽  
Significant Difference ◽  
Dsdna Antibodies

AbstractObjectivesData on the clinical importance of the detection of anti-dsDNA antibodies in patients with negative indirect immunofluorescence on the HEp-2 cell (IIF) are sparse and are especially not available for all common commercially available assays. This study aimed to assess the clinical significance of anti-dsDNA antibodies determined by the Elia™ dsDNA assay in patients with negative IIF.MethodsWe retrospectively examined the medical records of 234 consecutive subjects with detectable anti-dsDNA antibodies determined by the Elia™ dsDNA assay.ResultsA total of 124 subjects with detectable anti-dsDNA autoantibodies were IIF-negative, but yielded positive or borderline results in the Elia™ CTD screen assay for antinuclear antibodies (ANA). Within this group, 6/49 IIF-negative patients (12%) with ANA-associated systemic autoimmune rheumatic disorders (AASARD) and 118/185 subjects (64%) with various other diseases (Non-AASARD) were identified. There was no statistically significant difference with regard to the concentrations of anti-dsDNA antibodies (p=0.53) between the AASARD and the Non-AASARD group. Within the AASARD group, four patients diagnosed with systemic lupus erythematosus (SLE, treated), discoid lupus erythematosus (untreated), indetermined connective tissue disease (untreated) and polymyositis (treated) had positive anti-dsDNA autoantibodies, whereas two patients with treated SLE, thereby one in remission, had borderline concentrations of anti-dsDNA antibodies.ConclusionsOur findings suggest that the detection of anti-dsDNA antibodies in IIF-negative patients can be of clinical relevance in some cases. Our results further support the combined use of IIF and solid-phase assays in screening algorithms for ANA, in order to avoid overlooking potentially important autoantibody entities.

scholarly journals Tocilizumab for massive refractory pleural effusion in an adolescent with systemic lupus erythematosus

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Arianna De Matteis ◽  
Emanuela Sacco ◽  
Camilla Celani ◽  
Andrea Uva ◽  
Virginia Messia ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Lupus Erythematosus ◽  
High Dose ◽  
Common Symptom ◽  
Systemic Lupus ◽  
Malar Rash ◽  
Case Presentation ◽  
Double Stranded Dna ◽  
First Case ◽  
History Of

Abstract Background Pleural effusion in systemic lupus erythematous (SLE) is a common symptom, and recent studies demonstrated that IL-6 has a pivotal role in its pathogenesis. Case presentation We report a case of a 15 years old Caucasian boy with a history of persistent pleural effusion without lung involvement or fever. Microbiological and neoplastic aetiologies were previously excluded. Based on the presence of pleuritis, malar rash, reduction of C3 and C4 levels and positivity of antinuclear antibody (ANA) and anti-double stranded DNA (dsDNA), the diagnosis of juvenile SLE (JSLE) was performed. Treatment with high dose of intravenous glucocorticoids and mycophenolate mofetil was started with partial improvement of pleural effusion. Based on this and on adults SLE cases with serositis previously reported, therapy with intravenous tocilizumab (800 mg every two weeks) was started with prompt recovery of pleural effusion. Conclusion To the best of our knowledge, this is the first case of JSLE pleuritis successfully treated with tocilizumab.

scholarly journals A WHO Reference Reagent for lupus (anti-dsDNA) antibodies: international collaborative study to evaluate a candidate preparation

2019 ◽  
Vol 78 (12) ◽  
pp. 1677-1680 ◽  
Author(s):  
Bernard J Fox ◽  
Jason Hockley ◽  
Peter Rigsby ◽  
Carl Dolman ◽  
Pier Luigi Meroni ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Collaborative Study ◽  
Test Methods ◽  
Common Reference ◽  
Double Stranded Dna ◽  
Reference Preparation ◽  
International Collaborative ◽  
And Control ◽  
Dsdna Antibodies ◽  
International Collaborative Study

IntroductionAntibodies against double-stranded DNA (anti-dsDNA) are a specific biomarker for systemic lupus erythematosus (SLE). The first WHO International Standard (IS) for anti-dsDNA (established in 1985), which was used to assign units to diagnostic tests, was exhausted over a decade ago.MethodsPlasma from a patient with SLE was first evaluated in 42 European laboratories. The plasma was thereafter used by the National Institute for Biological Standards and Control to prepare a candidate WHO reference preparation for lupus (anti-dsDNA) antibodies. That preparation, coded 15/174, was subjected to an international collaborative study, including 36 laboratories from 17 countries.ResultsThe plasma mainly contained anti-dsDNA, other anti-chromatin antibodies and anti-Ku. The international collaborative study showed that the field would benefit from 15/174 as a common reference reagent improving differences in performance between different assays. However, no statistically meaningful overall potency or assay parallelism and commutability could be shown.Conclusion15/174 cannot be considered equivalent to the first IS for anti-dsDNA (Wo/80) and was established as a WHO Reference Reagent for lupus (oligo-specific) anti-dsDNA antibodies with a nominal value of 100 units/ampoule. This preparation is intended to be used to align test methods quantifying levels of anti-dsDNA antibodies.

scholarly journals Immunization with a Peptide Surrogate for Double-stranded DNA (dsDNA) Induces Autoantibody Production and Renal Immunoglobulin Deposition

1998 ◽  
Vol 188 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Chaim Putterman ◽  
Betty Diamond
Keyword(s):  
Immune Response ◽  
Lupus Erythematosus ◽  
Inbred Strains ◽  
Autoantibody Production ◽  
Peptide Antigen ◽  
Double Stranded Dna ◽  
Dsdna Antibody ◽  
Antigen Peptide ◽  
Peptide Display ◽  
Dsdna Antibodies

Anti–double-stranded DNA (dsDNA) antibodies are the serologic abnormality characteristically associated with systemic lupus erythematosus (SLE) and may play an important role in disease pathogenesis. Although the anti-dsDNA antibodies present in SLE are indicative of an antigen-driven response, the antigen has not been conclusively identified. By screening a phage peptide display library, we demonstrated previously that the decapeptide DWEYSVWLSN is specifically bound by the pathogenic murine IgG2b anti-dsDNA antibody R4A. To investigate the possibility that a protein antigen might trigger lupus-like autoimmunity, we immunized BALB/c mice with DWEYSVWLSN in adjuvant. Mice developed significant titers of IgG anti-dsDNA antibodies 2–3 wk after the initial immunization. Immunized mice also developed antibodies against some other lupus autoantigens, and immunoglobulin deposition was present in renal glomeruli at 49 d. Although an immune response to peptide and dsDNA was evident in BALB/c mice, there was little response in other inbred strains. This study demonstrates that lupus-like anti-dsDNA reactivity can be generated in nonautoimmune mice by immunization with a peptide antigen. Peptide-induced autoimmunity may prove useful in understanding the spreading of antigenic specificities targeted in SLE. However, most importantly, the demonstration that a peptide antigen can initiate a SLE-like immune response opens a new chapter on the potential antigenic stimuli that might trigger SLE.

scholarly journals Complete resolution of juvenile neuropsychiatric lupus with low dose rituximab

2021 ◽  
pp. 354-356
Author(s):  
Chanchal Gera ◽  
Gurpreet Singh Kochar ◽  
Sushma Sraw ◽  
Smriti Deswal
Keyword(s):  
Lupus Erythematosus ◽  
Complete Resolution ◽  
Low Dose ◽  
Resonance Imaging ◽  
Juvenile Systemic Lupus Erythematosus ◽  
Double Stranded Dna ◽  
Positive Antinuclear Antibody ◽  
Neuropsychiatric Sle ◽  
Granulomatous Lymphadenitis ◽  
History Of

Nervous system involvement leads to high mortality in juvenile systemic lupus erythematosus. We present the case of a 12-year-old girl who was admitted with a history of recurrence of fever, cervical swellings, seizure, and delirium. Approximately 6 months back, she was started on antitubercular therapy (ATT) for fever and granulomatous lymphadenitis. She developed a recurrence of fever, new cervical swellings, seizures, and delirium while she was continuing ATT. Magnetic Resonance Imaging brain revealed multiple hyperintensities in bilateral basal ganglia, temporal, and hippocampal regions. The patient was diagnosed to have lupus based on clinical features, positive antinuclear antibody, positive double-stranded DNA antibody, and hypocomplementemia. To avoid cyclophosphamide-related gonadotoxicity in this young girl, Rituximab was given. She was treated with two doses of Rituximab and there was complete resolution of her neuropsychiatric SLE. Rituximab can be considered over cyclophosphamide in children to avoid gonadotoxicity.

scholarly journals Clinical and Serological Associations with the Development of Incident Proteinuria in Danish Patients with Systemic Lupus Erythematosus

2018 ◽  
Vol 45 (7) ◽  
pp. 934-941 ◽  
Author(s):  
Nima Tanha ◽  
Renata Baronaite Hansen ◽  
Christoffer Tandrup Nielsen ◽  
Mikkel Faurschou ◽  
Søren Jacobsen
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Cox Regression ◽  
Subsequent Development ◽  
Systemic Lupus ◽  
Vital Status ◽  
Younger Age ◽  
History Of ◽  
Dsdna Antibodies

Objective.In a longitudinal cohort study, we investigated whether clinical and serological manifestations at the time of classification of systemic lupus erythematosus (SLE) were predictive of subsequent development of incident proteinuria as a biomarker of incident lupus nephritis.Methods.Patients fulfilling SLE classification criteria but having no proteinuria prior to or at the time of classification were included. Data on SLE manifestations, vital status, criteria-related autoantibodies, and SLE-associated medications were collected during clinical visits and supplemented by chart review. HR were calculated by Cox regression analyses.Results.Out of 850 patients with SLE, 604 had not developed proteinuria at the time of SLE classification. Of these 604 patients, 184 (30%) developed incident proteinuria following SLE classification. The patients had a median followup of 11 years and 7 months. Younger age and history of psychosis at the time of classification were associated with development of incident proteinuria, just as were lymphopenia (HR 1.49, 95% CI 1.08–2.06), anti-dsDNA (HR 1.38, 95% CI 1.01–1.87), and a high number of autoantibodies (HR 1.26, 95% CI 1.06–1.48).Conclusion.The risk of incident proteinuria after onset of SLE was increased by the presence of lymphopenia, anti-dsDNA antibodies, psychosis, younger age, and a high number of autoantibodies at onset.

Negative Double Stranded DNA and Anti-Smith Antibodies in Lupus Nephritis

2012 ◽  
Vol 4 (2) ◽  
pp. 55-57
Author(s):  
Gagangeet Sandhu ◽  
Anip Bansal ◽  
Aditi Ranade ◽  
Ritu Aggarwal ◽  
Gopal Narayanswami ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Autoimmune Disease ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Drug Induced ◽  
Serological Screening ◽  
Double Stranded Dna ◽  
Dsdna Antibodies

Systemic lupus erythematosus (SLE) is an autoimmune disease in which auto-antibodies are generated against a variety of intracellular antigens. Anti-Smith (Sm) and anti-double stranded DNA (dsDNA) antibodies in particular are considered to be nephritogenic and their role and correlation with lupus nephritis (LN) has been well established. We present here a case in which the patient had diffuse proliferative full house severe LN, yet negative ds-DNA and anti-Sm antibodies. Although extremely rare, a few subsets of patients with drug-induced LN (hydralazine) have been described in the literature to have negative dsDNA and anti-Sm antibodies on serological screening. Our patient, however, had no evidence of drug induced LN. On further review, and similar to our case, we found only 6 additional well documented cases of non-drug induced severe LN with negative dsDNA antibodies.

scholarly journals Performance Characteristics of Different Anti-Double-Stranded DNA Antibody Assays in the Monitoring of Systemic Lupus Erythematosus

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Michael Mahler ◽  
Chelsea Bentow ◽  
Tyler O’Malley ◽  
Claudia Ibarra ◽  
John Conklin ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Mixed Effects ◽  
Performance Characteristics ◽  
High Avidity ◽  
Systemic Lupus ◽  
Complement Components ◽  
Linear Mixed Effects ◽  
Double Stranded Dna

Objective. We sought to evaluate different anti-double-stranded DNA assays for their performance characteristics in monitoring disease activity fluctuations in systemic lupus erythematosus (SLE). Methods. 36 active SLE patients were followed monthly. At each study visit (total n=371), blood was collected and disease activity was scored using the SELENA-SLEDAI (excluding anti-dsDNA or complement components) and by a physician’s global assessment (PGA). Four anti-dsDNA tests were compared. Linear mixed-effects models with random intercept and fixed slopes were used to evaluate the relationship between the longitudinal fluctuations of disease activity and anti-dsDNA titers. Results. At enrollment, positivity for QUANTA Lite and high-avidity anti-dsDNA assay was both 64% and significantly lower than anti-dsDNA positivity by QUANTA Flash (83%) and CLIFT (96%). Linear mixed-effects modeling indicated that the change in clinical SELENA-SLEDAI scores was associated with the titers of all anti-dsDNA with QUANTA Flash yielding the highest marginal R2 (0.15; p<0.01). QUANTA Flash was the only anti-dsDNA assay significantly associated with the change in PGA (marginal R2=0.05; p<0.01). Conclusion. These data indicate that anti-dsDNA antibodies determined by QUANTA Flash have a value in monitoring SLE disease activity.

Uncontrollable Seizures in an Epileptic

1977 ◽  
Vol 11 (10) ◽  
pp. 590-594
Author(s):  
John E. Zarek
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Seizure Control ◽  
Underlying Disease ◽  
Blood Levels ◽  
Systemic Lupus ◽  
Drug Induced ◽  
Double Stranded Dna ◽  
History Of ◽  
History Of Epilepsy

A case of possible phenytoin-induced systemic lupus erythematosus is presented in a patient with a twenty-year history of epilepsy. The failure of seizure control in the presence of adequate anticonvulsant blood levels pointed to an underlying disease state. Drug-induced and idiopathic systemic lupus erythematosus are quite similar in clinical and laboratory manifestations. However, antibodies to native (double-stranded)-DNA seem to be consistent with the idiopathic form. A review of drug-induced systemic lupus erythematosus is presented.

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