Clinical significance of anti‐glomerular basement membrane antibodies in a cohort of Chinese patients with lupus nephritis

Abstract

Objectives: To evaluate the clinical and laboratory features of patients with lupus nephritis (LN) in the presence and absence of anti‐glomerular basement membrane antibodies (anti‐GBM) and to establish whether the characteristics of the disease correlate with anti‐GBM.

Methods: We performed a retrospective study of 157 hospitalised patients with systemic lupus erythematosus (SLE), 91 of whom had LN. The test for anti‐GBM used an enzyme‐linked immunosorbent assay (ELISA). Clinical and laboratory data were collected and assessed in LN patients with and without anti‐GBM.

Results: Anti‐GBM was detected in 14 (8.9%) of 157 patients with SLE. All of the 14 patients developed LN; of these, 10 reached the criteria for crescentic glomerulonephritis (CGN) and five were diagnosed as Goodpasture's disease. Serum anti‐GBM levels were correlated with the presence of both anti‐double‐stranded DNA antibodies (anti‐dsDNA) and anti‐nucleosome antibodies (anti‐NuA). Significant differences in extrarenal clinical manifestations were found between anti‐GBM‐positive and ‐negative LN patients, with regard to pleuritis, pulmonary haemorrhage, sinusitis, and anaemia in particular.

Conclusions: LN with anti‐GBM is not rare in Chinese patients. Anti‐GBM, together with the additional nephritogenic potential of anti‐dsDNA and anti‐NuA, may play an essential role in the pathogenesis of the anti‐GBM disease in LN. Therefore, in addition to routine anti‐GBM assay, anti‐dsDNA and anti‐NuA measurements should be performed early to ensure a prompt diagnosis and immediate treatment in patients with anti‐GBM‐mediated disease.