Prevalence and clinical significance of ANCA positivity in lupus nephritis: a case series of 116 patients and literature review

• Published in: Journal of nephrology 2023-05, Vol.36 (4), p.1059-1070
• Main Authors: Lacetera, Rosanna, Calatroni, Marta, Roggero, Letizia, Radice, Antonella, Pozzi, Maria Rosa, Reggiani, Francesco, Sciascia, Savino, Trezzi, Barbara, Roccatello, Dario, Minetti, Enrico, Moroni, Gabriella, Sinico, Renato Alberto
• Format: Article
• Language: English
• Subjects: Antibodies, Antineutrophil Cytoplasmic; Clinical Relevance; Humans; Lupus Nephritis - diagnosis; Lupus Nephritis - drug therapy; Lupus Nephritis - epidemiology; Medicine; Medicine & Public Health; Nephrology; original Article; Prevalence; Retrospective Studies; Urology
• ISSN: 1724-6059; 1724-6059
• DOI: 10.1007/s40620-023-01574-3

The prevalence and clinical significance of anti-neutrophil cytoplasmic antibodies [ANCAs] in patients with lupus nephritis [LN] is not fully elucidated. Our aim was to determine whether LN patients with ANCA positivity had different clinicopathological features and outcomes compared to ANCA-negative patients. Methods. Among our LN patients we retrospectively selected those who underwent ANCA testing the day of the kidney biopsy and before the start of induction treatment. Clinical/histopathological features at kidney biopsy and renal outcome of ANCA-positive patients were compared with those of ANCA-negative subjects. Results. We included 116 Caucasian LN patients in the study; 16 patients [13.8%] were ANCA-positive. At kidney biopsy, ANCA-positive patients presented more frequently with an acute nephritic syndrome than ANCA-negative ones; the difference however does not reach statistical significance [44 vs. 25%, p  = 0.13]. At histological evaluation, proliferative classes [100% vs 73%; p  = 0.02], class IV [68.8% vs 33%; p