Published online May 1, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. 1663-1668 (doi:10.1542/peds.2005-1148)
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Clinical Value of Autoantibodies Against C1q in Children With Glomerulonephritis

Ina Kozyro, MDa, Iryna Perahudb, Salima Sadallah, MDc, Alexander Sukalo, MDa, Leonid Titov, PhDd, Jürg Schifferli, MD PhDc,e and Marten Trendelenburg, MDb,e

a Department of Pediatrics, 2nd Children's Hospital
d Department of Microbiology, Immunology and Virology, Belarus State University, Minsk, Belarus
b Laboratories of Clinical Immunology
c Immunonephrology, Department of Research
e Internal Medicine B, University Hospital Basel, Basel, Switzerland

OBJECTIVE. Autoantibodies against C1q (anti-C1q) have been found in a number of autoimmune and renal diseases. They are best described in adult patients with systemic lupus erythematosus, where a strong correlation between the occurrence of anti-C1q and severe lupus nephritis (LN) has been observed. However, the role of anti-C1q in children with systemic lupus erythematosus has not yet been determined. Furthermore, the clinical importance of anti-C1q in other forms of glomerulonephritis remains to be elucidated. The aim of this study was to investigate anti-C1q in children with different forms of glomerulonephritis including LN.

METHODS. We prospectively investigated 112 children with different forms of newly diagnosed glomerulonephritis for the presence of anti-C1q by an enzyme-linked immunosorbent assay and compared them with healthy controls. Associations between anti-C1q and disease manifestations at the time of the measurements and during follow-up were investigated.

RESULTS. Twenty-one of 112 patients were positive for anti-C1q compared with 0 of 40 healthy controls. Anti-C1q was associated with activity in LN and with disease severity in patients with acute poststreptococcal glomerulonephritis (APSGN). In LN, 7 of 12 patients were found to be anti-C1q positive. Six of these 7 had active disease at the time of the serum sampling compared with 1 of 5 of the anti-C1q-negative children. In children with APSGN, 8 of 24 were positive for anti-C1q. Anti-C1q-positive APSGN patients had significantly higher proteinuria and more often hypertension than those without anti-C1q. All 4 patients in which APSGN did not resolve spontaneously were anti-C1q positive.

CONCLUSIONS. Anti-C1q is associated with active LN in children. In addition, children with anti-C1q-positive APSGN have more severe disease than those who are anti-C1q negative. These data suggest APSGN is another disease in which anti-C1q has a pathogenic role.

Key Words: glomerulonephritis • autoantibody • complement

Abbreviations: SLE—systemic lupus erythematosus • LN—lupus nephritis • ELISA—enzyme-linked immunosorbent assay • APSGN—acute poststreptococcal glomerulonephritis

Accepted Oct 17, 2005.


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