Differential diagnosis of systemic lupus erythematosus and rheumatoid arthritis with complements C3 and C4 and C-reactive protein

Li, Wenhui; Song, Wuqi; Hu, Yunlong; Liu, Yanhong; Da, Rong; Chen, Xiaobei; Li, Yang; Ling, Hong; Zhong, Zhaohua; Zhang, Fengmin

doi:10.3892/etm.2013.1304

Cited by 30 publications

(25 citation statements)

References 18 publications

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“…11 At the same time, the complement levels were found to increase in inflammatory pathologies. 12 That's why decreased MPV, C3 and C4; increased CRP, ASO, C3, and C4 were evaluated as risk factors. The clinical and laboratory findings predicting the organ or system involvement were tried to be determined.…”

Section: Methodsmentioning

confidence: 99%

Determination of Risk Factors in Children Diagnosed With Henoch-Schönlein Purpura

Kılıç

2018

Arch Rheumatol

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Objectives: This study aims to evaluate the frequency of skin, gastrointestinal, joint, and renal involvement in children with Henoch-Schönlein purpura (HSP) and investigate the risk factors for organ/system involvement. Patients and methods: The data of 186 patients (97 boys, 89 girls; mean age 7.4±2.8 years; range 1.5 to 16.5 years) who were followed-up with the diagnosis of HSP in our clinic between October 2011 and December 2013 were evaluated retrospectively. Results: Logistic regression analysis revealed that the risk of gastrointestinal system (GIS) involvement was significantly higher in patients with skin lesions in the upper extremities (p=0.002, odds ratio [OR]=3.2). The risk of joint involvement was significantly higher in girls (p=0.024, OR=2.18), in patients with soft tissue swelling (p=0.005, OR=2.63), and with low mean platelet volume (MPV) levels (p=0.008, OR=4.07). The risk of renal involvement was significantly higher in girls (p=0.047, OR=2.7), in patients >10 years (p=0.001, OR=1.4), and in patients with elevated C-reactive protein (CRP) levels (p=0.007, OR=6.57). Conclusion: Having skin lesions in the upper extremities is a risk factor for GIS involvement. Female sex, soft tissue swelling, and low MPV levels are risk factors for joint involvement. Female sex, >10 years of age, and high CRP levels are risk factors for renal involvement. Renal involvement in HSP is independent of GIS or joint involvement and very close follow-up is required in the acute period particularly in girls >10 years with high CRP levels.

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Section: Methodsmentioning

confidence: 99%

Determination of Risk Factors in Children Diagnosed With Henoch-Schönlein Purpura

Kılıç

2018

Arch Rheumatol

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“…With respect to C4, there is still some uncertainty about the use of this parameter as biomarker for the diagnosis of lupus activity. One study reported that serum levels of C4 are useful in disease activity evaluation in patients with SLE [ 59 ]. In contrast, another study found that serum levels of C4 split product C4d rather than C4 can be used as biomarker for lupus activity [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

Coagulation cascade and complement system in systemic lupus erythematosus

Liang

Xie

et al. 2017

Oncotarget

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This study was conducted to (1) characterize coagulation cascade and complement system in systemic lupus erythematosus (SLE); (2) evaluate the associations between coagulation cascade, complement system, inflammatory response and SLE disease severity; (3) test the diagnostic value of a combination of D-dimer and C4 for lupus activity. Transcriptomics, proteomics and metabolomics were performed in 24 SLE patients and 24 healthy controls. The levels of ten coagulations, seven complements and three cytokines were measured in 112 SLE patients. Clinical data were collected from 2025 SLE patients. The analysis of multi-omics data revealed the common links for the components of coagulation cascade and complement system. The results of ELISA showed coagulation cascade and complement system had an interaction effect on SLE disease severity, this effect was pronounced among patients with excess inflammation. The analysis of clinical data revealed a combination of D-dimer and C4 provided good diagnostic performance for lupus activity. This study suggested that coagulation cascade and complement system become ‘partners in crime’, contributing to SLE disease severity and identified the diagnostic value of D-dimer combined with C4for lupus activity.

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“…Mosca et al [ 32 ] suggested that an elevated C4 level could be associated with intermittent atopic asthma. Meanwhile, many studies have identified that C4 might be a biomarker for forecasting systemic lupus erythematosus [ 33 – 34 ]. Therefore, C4 might be related to acute inflammation and the immune response.…”

Section: Discussionmentioning

confidence: 99%

Serum Homocysteine Concentration Is Significantly Associated with Inflammatory/Immune Factors

Chen

et al. 2015

PLoS ONE

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Recent studies suggest that serum homocysteine (HCY) level is correlated to inflammatory/immune factors that influence the development and progression of many diseases, such as cardiovascular disease. However, the association between serum HCY level and inflammatory/immune factors in healthy populations has not been systematically investigated. This study was conducted based on the Fangchenggang Area Male Health and Examination Survey (FAMHES) project. After comprehensive baseline analysis, we could not find any significant association between HCY level and inflammatory/immune factors. However, in the next linear regression analysis, serum C4 [age-adjusted: Beta = -0.053, 95%CI = (-3.798, -0.050), P = 0.044; multivariate adjusted: Beta = -0.064, 95%CI = (-4.271, -0.378), P = 0.019] and C-reactive protein (CRP) concentration [unadjusted: Beta = 0.056, 95%CI = (0.037, 0.740), P = 0.030] were positively related with HCY. In further binary regression analysis, a significant correlation was confirmed for C4 and HCY [age-adjusted: OR = 0.572, 95%CI = (0.359, 0.911); multivariate adjusted: OR = 0.558, 95%CI = (0.344, 0.905)]. In order to discover more potential associations, multivariate logistic regression analysis was applied and suggested that HCY and C4 were significantly correlated [age-adjusted: OR = 0.703, 95%CI = (0.519, 0.951); multivariate adjusted: OR = 0.696, 95%CI = (0.509, 0.951)]. In addition, immunoglobulin M (IgM) may influence the HCY level to some extent [unadjusted: OR = 1.427, 95%CI = (1.052, 1.936); age-adjusted: OR = 1.446, 95%CI = (1.061, 1.970); multivariate adjusted: OR = 1.447, 95%CI = (1.062, 1.973)]. Combining our results with recent studies, we propose that C4, CRP, and IgM in serum are significantly associated with HCY concentration. Further studies are needed on the mechanism of the interaction, especially among cardiovascular disease subjects.

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Differential diagnosis of systemic lupus erythematosus and rheumatoid arthritis with complements C3 and C4 and C-reactive protein

Cited by 30 publications

References 18 publications

Determination of Risk Factors in Children Diagnosed With Henoch-Schönlein Purpura

Determination of Risk Factors in Children Diagnosed With Henoch-Schönlein Purpura

Coagulation cascade and complement system in systemic lupus erythematosus

Serum Homocysteine Concentration Is Significantly Associated with Inflammatory/Immune Factors

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