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Pediatric Nephrology
Published in: Pediatric Nephrology 9/2017

01-09-2017 | Original Article

Anti-C1q autoantibodies as markers of renal involvement in childhood-onset systemic lupus erythematosus

Authors: Cécile Picard, Jean-Christophe Lega, Bruno Ranchin, Pierre Cochat, Natalia Cabrera, Nicole Fabien, Alexandre Belot

Published in: Pediatric Nephrology | Issue 9/2017

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Abstract

Background

Childhood-onset systemic lupus erythematosus (cSLE) is rare, and considered more severe than its adult-onset counterpart. Lupus nephritis (LN) occurs more frequently in children, accounting for higher long-term morbidity and mortality compared with adults. Thus, reliable biological markers are needed to predict disease course. This study aimed to investigate the capacity of anti-C1q autoantibodies (Abs) to predict renal flare and global disease activity in cSLE patients, and association with disease activity and kidney involvement.

Methods

Twenty-eight patients with cSLE including 19 patients (68%) with a history of LN were included retrospectively. Anti-C1q Abs were analysed by ELISA at renal flare-up or in the quiescent phase of disease and compared with Farr dsDNA assay.

Results

Thirty-one flares occurred during follow-up: anti-C1q Abs were positive in 26 (84%), strongly associated with active disease status (p < 0.0001), and correlated with global disease activity score (p < 0.0001) and anti-dsDNA Abs presence (p < 0.0001). The specificity of anti-C1q Abs was higher than anti-dsDNA (73% vs 19%) in discriminating LN patients, whereas the receiver operating characteristic curves were not statistically different (0.83 ± 0.06 vs 0.78 ± 0.08 respectively), similar to C3 dosage. The presence of anti-C1q Abs at diagnosis was not predictive for global or renal flare. Introduction of a modified SLEDAI score excluding dsDNA Abs, demonstrated a stronger correlation of anti-C1q Abs titres with SLEDAI score in comparison with the Farr test.

Conclusion

Anti-C1q Abs seem very specific to flares, including LN in children, and their role in daily practice compared with the Farr dsDNA assay needs to be defined.
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Metadata
Title
Anti-C1q autoantibodies as markers of renal involvement in childhood-onset systemic lupus erythematosus
Authors
Cécile Picard
Jean-Christophe Lega
Bruno Ranchin
Pierre Cochat
Natalia Cabrera
Nicole Fabien
Alexandre Belot
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 9/2017
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-017-3646-z

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