AI Article Synopsis
- The study examines lupus nephritis (LN) in patients with systemic lupus erythematosus (SLE), comparing characteristics of those diagnosed early (within one year of SLE) versus those diagnosed later (more than one year after SLE).
- It analyzed medical records from 331 LN patients treated at a Polish hospital between 2012 and 2022, focusing on demographics, clinical details, and laboratory test results, with statistical methods used to identify key factors affecting LN development.
- Findings indicate that delayed-onset LN patients are generally younger at SLE diagnosis and exhibit more severe symptoms, along with a higher occurrence of specific autoantibodies, highlighting the importance of monitoring and early diagnosis in non-LN SLE
Article Abstract
Background: Lupus nephritis (LN) manifests systemic lupus erythematosus (SLE) and is characterized by various clinical and laboratory features. This study aimed to comprehensively evaluate the characteristics of LN patients according to the time of LN diagnosis: early-onset (LN diagnosed within one year from SLE diagnosis) vs. delayed-onset (LN diagnosed more than one year after SLE diagnosis).
Methods: We conducted a retrospective analysis of medical records from all SLE patients treated at the University Hospital in Kraków, Poland, from 2012 to 2022. We collected data on demographic, clinical, and laboratory characteristics, including histological findings, treatment modalities, and disease outcomes. Statistical analyses were performed to identify factors impacting LN development and prognosis.
Results: Among 331 LN patients, early-onset was diagnosed in 207 (62.54%) and delayed-onset was documented in 122 cases (36.86%). In 2 (0.6%) LN cases, the time of first kidney manifestation in the SLE course was unknown. Delayed-onset LN had a higher female-to-male ratio and younger age at SLE diagnosis. This group was associated with more severe clinical manifestations. In turn, studied subgroups did not differ in internist comorbidities, kidney histopathology, and family history regarding autoimmune diseases. Delayed-onset LN exhibited a higher frequency of anti-dsDNA, anti-Smith, anti-Ro, anti-RNP, and anti-cardiolipin IgG autoantibodies. During a 14-year follow-up period, 16 patients died. Mortality rate and causes of death were comparable in both analyzed subgroups.
Conclusions: More severe clinical manifestations in delayed-onset LN prompt strict monitoring of non-LN SLE patients to diagnose and treat kidney involvement early. Also, recognizing the higher frequency of autoantibodies such as anti-dsDNA or anti-Smith in delayed-onset LN underscores the potential value of autoantibody profiling as a diagnostic and prognostic tool.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178551 | PMC |
| http://dx.doi.org/10.1007/s00296-024-05579-4 | DOI Listing |
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