Serum IL-18 as biomarker in predicting long-term renal outcome among pediatric-onset systemic lupus erythematosus patients

An urge of biomarker identification is needed to better monitor lupus nephritis (LN) disease activity, guide clinical treatment, and predict patient's long-term outcome. With the proinflammatory effect and its association with inflammasomes, the significance of interleukin-18 (IL-18) among pedi...

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Bibliographic Details
Published in:Medicine (Baltimore) 2016-10, Vol.95 (40), p.e5037-e5037
Main Authors: Wu, Chao-Yi, Yang, Huang-Yu, Yao, Tsung-Chieh, Liu, Su-Hsun, Huang, Jing-Long
Format: Article
Language:English
Subjects:
Adolescent
Biomarkers - blood
Biomarkers - urine
Biopsy
Child
Child, Preschool
Diagnostic Accuracy Study
Disease Progression
Female
Follow-Up Studies
Forecasting
Humans
Interleukin-18 - metabolism
Kidney - pathology
Kidney Failure, Chronic - diagnosis
Kidney Failure, Chronic - etiology
Kidney Failure, Chronic - metabolism
Lupus Erythematosus, Systemic - complications
Lupus Erythematosus, Systemic - diagnosis
Lupus Erythematosus, Systemic - metabolism
Male
Prognosis
Retrospective Studies
Severity of Illness Index
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Summary:An urge of biomarker identification is needed to better monitor lupus nephritis (LN) disease activity, guide clinical treatment, and predict patient's long-term outcome. With the proinflammatory effect and its association with inflammasomes, the significance of interleukin-18 (IL-18) among pediatric-onset systemic lupus erythematous (pSLE) patient, especially, its importance in predicting long-term renal outcome was investigated.In a pSLE cohort of 96 patients with an average follow-up period of 10.39 ± 3.31 years, clinical data and laboratory workups including serum IL-18 were collected at time of disease onset and 6 months after treatment despite their initial renal status. Through Cox regression analysis, the parameters at baseline and at 6 months posttreatment were carefully analyzed.Average age of all cases was 12.74 ± 3.01 years old and 65 of them underwent renal biopsy at the time of diagnosis. Nine subjects (9.38%) progressed to end-stage renal disease (ESRD) and 2 cases (2.08%) died during follow-up. Through multivariate analysis, serum IL-18 level 6 months posttreatment was found to be the most unfavorable factor associating poor clinical outcome despite patient's initial renal status. In addition, the presentation of serum IL-18 in its correlation with SLE global disease activity as well as the presence and severity of LN were all significant (P 
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000005037