Systemic Erythematosus Lupus and Albumin-Globulin Index, a specific finding in lupus flares?
Keywords:
Lupus Erythematosus, Systemic, Autoimmunity, Globulins, Immunoglobulins, Serum Albumin, Lupus NephritisAbstract
Introduction: Systemic lupus erythematosus (SLE) is the model of autoimmune disease. Several types of immunoglobulins are involved in the development of the disease, mainly IgG, IgM and IgA.
Objective: To describe the potential use of the albumin/globulin ratio as an indicator of activity in SLE.
Development: fifty per cent of patients with SLE exhibit hypoalbuminemia with hypergammaglobulinemia in the disease activity periods. Hypoalbuminemia is mainly related to the presence of lupus nephritis. The half of patients with lupus nephritis develop proteinuria with values of nephrotic syndrome. The proteinuria equals or partially reverses the albumin/globulin ratio. The inverted albumin/globulin ratio is insufficient to establish the presence of lupus activity. Other clinical entities producing polyclonal hypergammaglobulinaemia should be excluded. The SLE activity criteria increase the sensitivity of the inverted albumin/globulin ratio.
Conclusions: the interpretation of the albumin/globulin ratio requires the activity estimation by differents clinical criteria (SLICC, SLEDAI, BILAG, etc.). The inverted albumin/globulin ratio can not be interpreted as a stand-alone indicator of disease activity in every SLE patients.
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