Rheumatology International

, Volume 39, Issue 5, pp 879–884 | Cite as

ANCA positivity at the time of renal biopsy is associated with chronicity index of lupus nephritis

  • Jung Yoon Pyo
  • Seung Min Jung
  • Jason Jungsik Song
  • Yong-Beom Park
  • Sang-Won LeeEmail author
Observational Research


We investigated the association of antineutrophil cytoplasmic antibody (ANCA) positivity with lupus nephritis (LN) activity, histological features and prognosis in Korean patients with biopsy-proven LN having the results of both myeloperoxidase (MPO–ANCA) and proteinase 3 (PR3)–ANCA. We retrospectively reviewed the medical records of 91 LN patients having the results of ANCA. We divided patients with LN into the two groups according to the ANCA positivity. We collected clinical and laboratory data at kidney biopsy and histological features such as LN class including class I, II, III, IV-S, IV-G and V, and activity and chronicity index. We evaluated prognosis of LN during the follow-up by death and kidney failure. Twelve of 91 patients (13.2%) had ANCA at kidney biopsy. There were no differences in demographic data, comorbidities, reasons for kidney biopsy and laboratory data at kidney biopsy between patients with and without ANCA. In 12 LN patients with ANCA, Class III was the most frequently observed LN class (41.7%), while in 79 LN patients without ANCA, class IV-G was the most often detected LN class (35.4%). There were no meaningful differences in classes of LN between the two groups. On the other hand, patients with ANCA exhibited the higher median chronicity index than those without (2.5 vs. 1.0, P = 0.028), unlike activity index. ANCA positivity exhibited no association with death or kidney failure during the follow-up. ANCA positivity at kidney biopsy is associated with chronicity index of LN.


Systemic lupus erythematosus Lupus nephritis Antineutrophil cytoplasmic antibody Histology Prognosis 


Author contributions

JYP and S-WL collected the data and analysed the results and wrote the manuscript, under the guidance of SMJ and JJS; Y-BP contributed to writing and critically reviewed the manuscript; JYP and SWL designed, analysed the results, critically reviewed the manuscript and wrote the final version. All authors read and approved the final manuscript.


This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2017R1D1A1B03029050).

Compliance with ethical standards

Conflict of interest


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the institutional Review Board of Severance Hospital (4-2017-0444).

Informed consent

The patient’s written informed consent was waived by the approving IRB, as this was a retrospective study.

Supplementary material

296_2019_4263_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 KB)
296_2019_4263_MOESM2_ESM.docx (16 kb)
Supplementary material 2 (DOCX 15 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Rheumatology, Department of Internal MedicineYonsei University Wonju College of MedicineWonjuRepublic of Korea
  2. 2.Division of Rheumatology, Department of Internal MedicineYonsei University College of MedicineSeoulRepublic of Korea
  3. 3.Institute for Immunology and Immunological DiseasesYonsei University College of MedicineSeoulRepublic of Korea

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