Clinical Differences in Lupus Nephritis in Thai Patients with Systemic Lupus Erythematosus with Positive vs. Negative Anti-dsDNA Antibody

Abstract

Objective: Anti-double strand deoxyribonucleic antibody (anti-dsDNA) is thought to trigger tissue inflammation-particularly in the kidney-in systemic lupus erythematosus (SLE). The association between anti-dsDNA and lupus nephritis (LN) has not been reported among Thais. The authors aimed to define the association between the clinical characteristics of positive vs. negative antidsDNA antibody in patients having SLE with LN. Materials and Methods: A historical cohort was conducted of SLE patients followed-up at Srinagarind Hospital, Khon Kaen University, Thailand, between January 2009 to December 2013. The authors excluded patients not tested for anti-dsDNA. Results: Of 132 SLE patients, the female was 123 cases. The respective mean age at onset and mean age during the study was 28.0±11 and 35.2±11.2 years. The mean duration of disease was 5.7±4.7 years. Ninety-six cases were tested for anti-dsDNA, of whom 73 (76%) were positive. There was a significant association between the presence of anti-dsDNA antibody and subnephrotic range proteinuria (p=0.048) and negative association with LN class IV A/C at onset (p=0.04). Conclusion: Anti-dsDNA was positive in around three-quarters of Thai SLE patients and the presence of the antibody was associated with renal involvement, particularly subnephrotic range proteinuria. Keywords: Systemic lupus erythematosus; Autoimmune diseases; Anti-dsDNA antibody; Lupus nephritis; Proteinuria