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Routine immunologic tests in systemic lupus erythematosus: is there a need for more studies?
- Source :
-
The Journal of rheumatology [J Rheumatol] 1996 Nov; Vol. 23 (11), pp. 1891-6. - Publication Year :
- 1996
-
Abstract
- Objective: To evaluate the sensitivity, specificity, and likelihood ratios of anti-dsDNA, C3, C4, and Clq binding tests for predicting flares in systemic lupus erythematosus (SLE) and to evaluate the conflicting results reported in the recent literature.<br />Methods: Test results from 9 to 3 months preceding 83 flares among 53 patients from a cohort study of 202 patients with SLE were assessed for their ability to predict renal and nonrenal flares and all flares combined. A flare was defined as a 6 point rise in a modified SLE Disease Activity Index.<br />Results: For all 4 tests, sensitivity approximated 50% and specificity was less than 75%. For anti-dsDNA, Clq binding, and C4, both positive and negative likelihood ratios were close to 1.0, suggesting little clinical value for routine testing. For C3, likelihood ratios for a positive test approximated 2.0, meeting the minimal level for clinical significance. Review of previous studies suggested that sample size, the use of a standardized disease activity measure to define a flare, the severity of the flare, and the study duration could not explain the discrepant results among studies. The 2 studies with testing every 4 to 6 weeks found that a rising anti-dsDNA predicted flares, while those with less frequent testing did not.<br />Conclusion: While our study provided no major support for routine testing with anti-dsDNA, C3, C4, or Clq binding, additional longitudinal studies are needed to assess monthly testing of anti-dsDNA as a predictor of flare in SLE.
- Subjects :
- Adult
Cohort Studies
Complement C1q analysis
Complement C3 analysis
Complement C4 analysis
DNA immunology
Female
Humans
Likelihood Functions
Lupus Erythematosus, Systemic physiopathology
Lupus Nephritis diagnosis
Lupus Nephritis immunology
Male
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Severity of Illness Index
Immunologic Tests
Lupus Erythematosus, Systemic diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 0315-162X
- Volume :
- 23
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- The Journal of rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 8923362