Clinical features and outcomes of patients with antineutrophil cytoplasmic antibody-positive systemic lupus erythematosus

Purpose To investigate the clinical characteristics, pathological features, and outcomes of patients with antineutrophil cytoplasmic antibody (ANCA)-positive systemic lupus erythematosus (SLE) in northwest China.Methods This retrospective study included 491 patients with SLE tested for ANCA antibodi...

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Main Authors: Ying Wang, Xiaoyang Yu, Xinfang Xie, Huixian Li, Wei Yang, Yu Liang, Wanhong Lu
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2235431
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author Ying Wang
Xiaoyang Yu
Xinfang Xie
Huixian Li
Wei Yang
Yu Liang
Wanhong Lu
author_facet Ying Wang
Xiaoyang Yu
Xinfang Xie
Huixian Li
Wei Yang
Yu Liang
Wanhong Lu
author_sort Ying Wang
collection DOAJ
description Purpose To investigate the clinical characteristics, pathological features, and outcomes of patients with antineutrophil cytoplasmic antibody (ANCA)-positive systemic lupus erythematosus (SLE) in northwest China.Methods This retrospective study included 491 patients with SLE tested for ANCA antibodies and 171 patients with ANCA-associated vasculitis (AAV) as controls. Subgroup analysis limited to those with renal involvement, and by ANCA antibody subtype (PR3 vs MPO). To compare the proteinuria remission rates between ANCA-positive and ANCA-negative lupus nephritis (LN) groups, a logistic regression model was used for propensity score matching based on age, hemoglobin, and baseline estimated glomerular filtration rate (eGFR).Results Compared to ANCA-negative SLE (n = 442), ANCA-positive SLE (n = 46) occur in older patients; however, these patients were younger than those with AAV (n = 167). The eGFR of patients with ANCA-positive LN (n = 25) was higher than that of patients having AAV with renal involvement (n = 56) but lower than that of patients with ANCA-negative LN (n = 163). Patients with SLE who had MPO-ANCA (n = 16) had higher levels of serum creatinine compared to those with PR3-ANCA (n = 30) (156.5 µmol/L vs. 45.5 µmol/L, p = 0.005). During the follow-up period, the remission rate of proteinuria in patients with ANCA-positive LN was lower than that of patients with ANCA-negative LN (50% vs. 75%, p = 0.008).Conclusion Patients with ANCA-positive LN may have worse baseline renal function and lower protein remission rates compared to patients with ANCA-negative LN. ANCA titers should be regularly monitored throughout the follow-up period in patients with SLE, especially in cases of renal involvement.
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spelling doaj-art-8fa739f8fa2f4fa3afb3a26592114fda2025-08-20T03:53:07ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2235431Clinical features and outcomes of patients with antineutrophil cytoplasmic antibody-positive systemic lupus erythematosusYing Wang0Xiaoyang Yu1Xinfang Xie2Huixian Li3Wei Yang4Yu Liang5Wanhong Lu6Department of General Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Nephrology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Geriatrics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Nephrology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Geriatrics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Nephrology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaDepartment of Nephrology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaPurpose To investigate the clinical characteristics, pathological features, and outcomes of patients with antineutrophil cytoplasmic antibody (ANCA)-positive systemic lupus erythematosus (SLE) in northwest China.Methods This retrospective study included 491 patients with SLE tested for ANCA antibodies and 171 patients with ANCA-associated vasculitis (AAV) as controls. Subgroup analysis limited to those with renal involvement, and by ANCA antibody subtype (PR3 vs MPO). To compare the proteinuria remission rates between ANCA-positive and ANCA-negative lupus nephritis (LN) groups, a logistic regression model was used for propensity score matching based on age, hemoglobin, and baseline estimated glomerular filtration rate (eGFR).Results Compared to ANCA-negative SLE (n = 442), ANCA-positive SLE (n = 46) occur in older patients; however, these patients were younger than those with AAV (n = 167). The eGFR of patients with ANCA-positive LN (n = 25) was higher than that of patients having AAV with renal involvement (n = 56) but lower than that of patients with ANCA-negative LN (n = 163). Patients with SLE who had MPO-ANCA (n = 16) had higher levels of serum creatinine compared to those with PR3-ANCA (n = 30) (156.5 µmol/L vs. 45.5 µmol/L, p = 0.005). During the follow-up period, the remission rate of proteinuria in patients with ANCA-positive LN was lower than that of patients with ANCA-negative LN (50% vs. 75%, p = 0.008).Conclusion Patients with ANCA-positive LN may have worse baseline renal function and lower protein remission rates compared to patients with ANCA-negative LN. ANCA titers should be regularly monitored throughout the follow-up period in patients with SLE, especially in cases of renal involvement.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2235431Anti-neutrophil cytoplasmic antibodiesclinicopathological characteristicslupus nephritissystemic lupus erythematosus
spellingShingle Ying Wang
Xiaoyang Yu
Xinfang Xie
Huixian Li
Wei Yang
Yu Liang
Wanhong Lu
Clinical features and outcomes of patients with antineutrophil cytoplasmic antibody-positive systemic lupus erythematosus
Renal Failure
Anti-neutrophil cytoplasmic antibodies
clinicopathological characteristics
lupus nephritis
systemic lupus erythematosus
title Clinical features and outcomes of patients with antineutrophil cytoplasmic antibody-positive systemic lupus erythematosus
title_full Clinical features and outcomes of patients with antineutrophil cytoplasmic antibody-positive systemic lupus erythematosus
title_fullStr Clinical features and outcomes of patients with antineutrophil cytoplasmic antibody-positive systemic lupus erythematosus
title_full_unstemmed Clinical features and outcomes of patients with antineutrophil cytoplasmic antibody-positive systemic lupus erythematosus
title_short Clinical features and outcomes of patients with antineutrophil cytoplasmic antibody-positive systemic lupus erythematosus
title_sort clinical features and outcomes of patients with antineutrophil cytoplasmic antibody positive systemic lupus erythematosus
topic Anti-neutrophil cytoplasmic antibodies
clinicopathological characteristics
lupus nephritis
systemic lupus erythematosus
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2235431
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