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Year : 2010  |  Volume : 5  |  Issue : 4  |  Page : 165-170

Anti-nucleosome antibodies may predict lupus nephritis and severity of disease in systemic lupus erythematosus

1 Immunology Laboratory, Habib Bourguiba University Hospital of Sfax, Tunisia
2 Department of Medicine, Hédi Chaker University Hospital of Sfax, Sfax, Tunisia
3 Department of Rheumatology, Hédi Chaker University Hospital of Sfax, Sfax, Tunisia
4 Department of Nephrology, Hédi Chaker University Hospital of Sfax, Sfax, Tunisia
5 Department of Psychiatry, Hédi Chaker University Hospital of Sfax, Sfax, Tunisia

Correspondence Address:
Haddouk Samy
Immunology Laboratory, Habib Bourguiba University Hospital of Sfax, Tunisia

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Source of Support: None, Conflict of Interest: None

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Background/Objective: Detection of anti-nucleosome antibodies in patients with systemic lupus erythematosus (SLE) has been well established and it is claimed that their presence is associated with disease activity. The objec- tive of this study is to determine the diagnostic value of anti-nucleosome antibodies in the assessment of lupus nephritis and clinically active SLE. Methods: The anti-nucleosome antibodies were evaluated in the serum of 200 Tunisian SLE patients at disease onset by a sensitive immunodot assay. Serum samples from each patient were also tested for ANA and anti-dsDNA antibody by IIF on Hep 2 cells and Crithidia luciliae respectively. During the follow-up, the patients were regularly monitored for clinical parameters. Global SLE activity was measured by the European Consensus Lupus Activity Measurement (ECLAM). Results: The prevalence of anti-nucleosome and anti-dsDNA antibodies was 69% and 63.5% respectively. Anti- nucleosome antibodies were found to be 30.1% positive in SLE patients lacking anti-dsDNA antibody. 79.5% patients had active SLE at the first clinical examination. Anti-nucleosome antibodies were more sensitive than anti- dsDNA antibodies to detect active SLE (78% vs. 71.7%, P = 0.19). 52.5% of SLE patients had renal involvement. Among these patients, the rate of anti-nucleosome positivity and anti-dsDNA were 77.1% and 67.6% respectively. The positivity of anti-nucleosome antibodies was significantly higher in patients with renal disease than the subjects without renal disease (P = 0.009). Anti-nucleosome and anti-ds DNA antibodies were significantly correlated with disease activity (P < 0.001 and P < 0.001 respectively). Conclusion: Anti-nucleosome antibody reactivity may be a useful marker in the diagnosis and assessment of active SLE.

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