Antibodies against nuclear antigens: Association with lupus nephritis1

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The predictive value of serological markers for the presence of Class IV (diffuse proliferative) glomerulonephritis in systemic lupus erythematosus (SLE) was investigated in a group of 96 patients with SLE. All patients with proteinuria greater than 1 g/24 hr, and/or urine sediment containing cellular casts or more than 6 erythrocytes/high-power field, and/or serum creatinine greater than 1.5 mg/dL (51 patients) underwent renal biopsy. Sixteen patients had Class IV glomerulonephritis. The combined presence of anti-native DNA, anti-Sm, and anti-RNP had a positive predictive value of 50.0% for Class IV nephritis (p = .0031), while the predictive value of negative anti-native DNA for absence of Class IV nephritis was 97.4% (p = .0019). We conclude that serological markers can be helpful in determining the need for renal biopsy in SLE.



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