Further description of early clinically silent lupus nephritis

Lupus. 2006;15(12):845-51. doi: 10.1177/0961203306070002.


Thirty silent lupus nephritis (SLN) patients were compared to 16 individuals bearing overt lupus nephritis (OLN). Results included: years of systemic lupus erythematosus (SLE) diagnosis were significantly earlier (4.6 +/- 2.8 years) in SLN than in OLN (7.18 +/- 3.61) (P < 0.05). Neurological compromise, hypertension, normocitic anemia and lymphopenia were significantly prevalent in OLN than in SLN (P < 0.05). Beside normal urinary sediment and renal function tests, the SLN group showed a moderate increase of both activity (AI) and chronicity (CI) renal pathology index when compared to highly increased AI and CI in OLN (P < 0.05). Seventy percent of SLN patients were ISN/RPS Classes I (6.6%) and II (63.3%) while 81% of OLN cases were Classes III, IV (37.5%) and V. IgG, IgA, IgM, lambda chain, C3 and fibrinogen immune deposits were found in 90% or over in both SLN and OLN individuals while in 60% or over, both groups also showed kappa chain, Clq and C4 deposits. While prevalence of ANA, anti-dsDNA and anti-C1q antibodies were similar in both groups, anti-histone, anti-RNP, CIC and CH50 serum levels were significantly different in OLN versus SLN (P < 0.05). We strongly suggest that indeed SLN is the earliest stage in the natural history of lupus nephritis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Autoantibodies / blood
  • Biopsy
  • Complement C1q / immunology
  • Complement C3 / immunology
  • DNA / immunology
  • Early Diagnosis
  • Female
  • Fibrinogen / immunology
  • Humans
  • Kidney / pathology
  • Lupus Nephritis / epidemiology
  • Lupus Nephritis / immunology*
  • Lupus Nephritis / pathology*
  • Male
  • Middle Aged
  • Seroepidemiologic Studies


  • Autoantibodies
  • Complement C3
  • Complement C1q
  • Fibrinogen
  • DNA