RT Journal Article
SR Electronic
T1 ANA positivity and complement level in pleural fluid are potential diagnostic markers in discriminating lupus pleuritis from pleural effusion of other aetiologies
JF Lupus Science & Medicine
JO Lupus Sci Med
FD Lupus Foundation of America
SP e000562
DO 10.1136/lupus-2021-000562
VO 8
IS 1
A1 Chen, Der-Yuan
A1 Huang, Yen-Hsiang
A1 Chen, Yi-Ming
A1 Chen, Jeremy J W
A1 Yang, Tsung-Ying
A1 Chang, Gee-Chen
A1 Tang, Kuo-Tung
YR 2021
UL http://lupus.bmj.com/content/8/1/e000562.abstract
AB Objective Lupus pleuritis is the most common pulmonary manifestation of systemic lupus erythematosus (SLE). We aimed to compare various biomarkers in discriminating between pleural effusions due to lupus pleuritis and other aetiologies.Methods We determined in 59 patients (16 patients with SLE and 43 patients without SLE) pleural fluid levels of high-mobility group box 1, soluble receptor for advanced glycation end products (sRAGE), adenosine deaminase (ADA), interleukin (IL) 17A, tumour necrosis factor-α, antinuclear antibodies (ANA), and complements C3 and C4.Results We found significant differences in the pleural fluid level of sRAGE, ADA, IL-17A, C3 and C4, and in the proportion of ANA positivity, among lupus pleuritis and other groups with pleural effusion. Specifically, ANA positivity (titre ≥1: 80) achieved a high sensitivity of 91%, specificity of 83% and negative predictive value (NPV) of 97% in discriminating lupus pleuritis from non-lupus pleural effusion. A parallel combination of the level of C3 (<24 mg/dL) and C4 (<3 mg/dL) achieved a sensitivity of 82%, specificity of 89% and NPV of 93% in discriminating lupus pleuritis from non-lupus exudative pleural effusion.Conclusions In conclusion, ANA, C3 and C4 in pleural fluid are useful in discriminating lupus pleuritis from pleural effusion due to other aetiologies with high NPV.Data are available upon reasonable request. Data are available from the corresponding author upon reasonable request.