Usefulness of skin immunofluorescence for distinguishing SLE from SLE-like renal lesions: a pilot study

Lupus nephritis (LN) may represent a diagnostic problem, particularly in pediatric patients that present with typical histological lesions but do not fulfill the American Rheumatism Association (ARA) criteria for the diagnosis of systemic lupus erythematosus (SLE). Based on the well-described deposi...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 2011, Vol.26 (1), p.77-83
Main Authors: L’Erario, Ines, Frezzolini, Alessandra, Ruggiero, Barbara, De Pità, Ornella, Emma, Francesco, Gianviti, Alessandra
Format: Article
Language:English
Subjects:
Adolescent
Biomarkers
Biopsy
Child
Complement System Proteins - metabolism
Diagnosis
Diagnosis, Differential
Female
Fluorescent antibody technique
Fluorescent Antibody Technique, Direct
Humans
Immunofluorescence
Immunoglobulins
Immunoglobulins - metabolism
Lupus
Lupus Erythematosus, Systemic - diagnosis
Lupus Erythematosus, Systemic - metabolism
Lupus Nephritis - diagnosis
Lupus Nephritis - metabolism
Male
Medicine
Medicine & Public Health
Microscopy
Nephrology
Original Article
Patients
Pediatrics
Pilot Projects
Retrospective Studies
Rheumatism
Skin
Skin - metabolism
Skin - pathology
Statistics, Nonparametric
Systemic lupus erythematosus
Urology
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Summary:Lupus nephritis (LN) may represent a diagnostic problem, particularly in pediatric patients that present with typical histological lesions but do not fulfill the American Rheumatism Association (ARA) criteria for the diagnosis of systemic lupus erythematosus (SLE). Based on the well-described deposition of immunoglobulins (Ig) and complement at the dermoepithelial junction in SLE, we hypothesized that skin biopsies may help in the diagnosis of LN. To test this hypothesis, we carried out a pilot study, performing a skin biopsy in 22 patients with LN and 13 patients with lupus-like lesions, regardless of the time elapsed from onset of renal disease. The latter group of patients was further divided into a purely renal group, designated as isolated full-house nephropathy (FHN), and a dubious cases group, presenting with additional clinical and biological features consistent with SLE but insufficient for diagnosing SLE. None of the 6 isolated FHN patients had positive skin immunofluorescence. Conversely, 5/7 patients in the dubious cases group ( p  
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-010-1655-2