Urinary abnormality in mixed connective tissue disease predicts development of other connective tissue diseases and decrease in renal function

Abstract

Objective To clarify the clinical significance of development of urinary abnormality in mixed connective tissue disease (MCTD). Methods Forty-one patients with an initial diagnosis of MCTD, followed at five hospitals between April 1, 2000 and December 31, 2013, were included. The relationship between urinary abnormality and various clinical parameters were retrospectively analyzed. Urinary abnormality was defined as proteinuria and/or hematuria detected by urinalysis. Development of other connective tissue diseases (CTDs) was defined as satisfaction of the criteria of each respective disease. Results Of 41 patients (34 females, 7 males, mean age at diagnosis 42.2 ± 15.2 years), 16 developed urinary abnormality (UrA(+) patients). The total incidences of development of other CTDs were higher in the UrA(+) patients than UrA(-) (62.5% versus 16.0%, p = .01). In the comparison between UrA(+) and UrA(-) patients, there were no significant differences in follow-up duration or last determined estimated glomerular filtration rate (eGFR), although eGFR decreased more significantly in the UrA(+) patients than UrA(-). (−20.2 ± 17.2 vs −6.1 ± 13.8 ml/min/1.73m2, p = .01; −21.0 ± 18.9 vs −6.7 ± 14.1%, p = .03) Conclusion Urinary abnormality during the clinical course in MCTD is predictive of a higher incidence of developing other CTDs. Furthermore, it might also predict long-term renal prognosis in patients with an initial diagnosis of MCTD.

Clinical significance of serum antinuclear antibodies in patients with autoimmune hepatitis and comorbidity

“…Secondly, the immune response of AIH-PBC patients is stronger, resulting in higher IgM than AIH patients, which was consistent with Ma's research [ 29 ]. In addition, we also found that AIH-CTD patients showed a lower level of serum K and MPV (Table 2 ), which may be due to the involvement of kidney and hematopoietic function in CTD patients, resulting in renal tubular acidosis [ 30 ]. In all, the clinical features of AIH complicated with different immune diseases are various.…”