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334 Serum il-18 as biomarker in predicting long-term renal outcome among pediatric-onset systemic lupus erythematosus patients
  1. KW Yeh1,
  2. CY Wu1,
  3. HY Yang2 and
  4. J L1
  1. 1Chang Gung Memorial Hospital, Paediatrics, Taoyuan, Taiwan R.O.C
  2. 2Chang Gung Memorial Hospital, Nephrology, Taoyuan, Taiwan R.O.C

Abstract

Background and Aims An urge of biomarker identification is needed to better monitor lupus nephritis (LN) disease activity, guide clinical treatment, and predict patient’s long-term outcome. With the proinflammatory effect and its association with inflammasomes, the significance of nterleukin-18 (IL-18) among pediatric-onset systemic lupus erythematous (pSLE) patient.

Methods In a pSLE cohort of 96 patients with an average follow-up period of 10.39±3.31 years, clinical data and laboratory workups including serum IL-18 were collected at time of disease onset and 6 months after treatment despite their initial renal status. Through Cox regression analysis, the parameters at baseline and at 6 months posttreatment were carefully analysed.

Results Average age of all cases was 12.74±3.01 years old and 65 of them underwent renal biopsy at the time of diagnosis. Nine(9.38%) progressed to end-stage renal disease (ESRD) and 2 (2.08%) died during follow-up. Through multivariate analysis, serum IL-18 level 6 months posttreatment was found to be the most unfavourable factor associating poor clinical outcome despite patient’s initial renal status. The presentation of serum IL-18 in its correlation with SLE global disease activity as well as the presence and severity of LN were all significant (p<0.001, p=0.03, and p=0.02, respectively). The histological classification of LN was not associated with the level of IL-18 among the pSLE patients (p=0.64).

Conclusions The role of serum IL-18 as biomarker representing global disease activity and status of renal flares among pSLE population was shown for the first time. Additionally, we have identified IL-18 at 6 months posttreatment a novel marker for long-term renal outcome prediction.

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