Serum complement values (C3 and C4) to differentiate between systemic lupus activity and pre-eclampsia☆
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Cited by (88)
Pregnancy in systemic lupus erythematosus
2023, Best Practice and Research: Clinical RheumatologyPregnancy in systemic lupus erythematosus and antiphospholipid syndrome
2017, Best Practice and Research: Clinical RheumatologyCitation Excerpt :For example, fatigue, mild thrombocytopenia, and anaemia, commonly encountered during pregnancy, may be mistaken for evidence of heightened disease activity. Similarly, changes in complement concentrations, classic serologic markers of SLE activity, may not be reliable biomarkers during pregnancy [33]. More recently, various instruments for measuring SLE activity have been adapted to pregnancy [34].
A comprehensive review of the clinical approach to pregnancy and systemic lupus erythematosus
2016, Journal of AutoimmunityCitation Excerpt :This distinction is critical because the two conditions are managed in opposite ways: LN requires immunosuppression, whereas for severe PE or eclampsia delivery, even very preterm, may be indicated. A detailed evaluation of other biomarkers of SLE activity, as anti-dsDNA titre, low level of complement, active urine sediment (red cells, white cells and cellular casts) and the presence of extra-renal SLE manifestation may be helpful [65–67]. Obstetrical and neonatal complications in LN pregnancy remain greater than in general population; favourable pregnancy outcome ranges from 65 to 90%.
The complement system and adverse pregnancy outcomes
2015, Molecular ImmunologyCitation Excerpt :Lupus flares in pregnancy are often characterized by severe hypertension and proteinuria, and distinction from severe preeclampsia is difficult. While preeclampsia is not characterized by low C3 or C4 levels as seen with lupus in pregnancy (Buyon et al., 1986), the ratio of complement split products (i.e., C3a/C3 and C4d/C4) are elevated in preeclampsia suggesting excess complement activation with relative depletion of C3 and C4 (Derzsy et al., 2010). On the other hand, both severe preeclampsia and lupus have been associated with increased terminal complement activation as measured by plasma and urine biomarkers C5a and sC5b-9 (Burwick et al., 2013; Chiu et al., 1998; Gou et al., 2013).
Dysregulated Complement Activation as a Common Pathway of Injury in Preeclampsia and Other Pregnancy Complications
2010, PlacentaCitation Excerpt :Indeed, complement activation products have been demonstrated in deciduas, chorionic villi and vessel walls in placentas of patients with aPL and in patients with preeclampsia [77,81,84]. Studies performed over a decade ago found evidence of complement activation in pregnant patients with SLE [75,76,85–87]. It may be difficult to identify decreased complement synthesis or increased consumption due to lupus because changes induced by gestation can either falsely normalize (if synthesis increases) or exaggerate (if synthesis does not increase) disease-related hypocomplementemia [75,76,88].
Activation of the complement system in normal pregnancy and preeclampsia
2010, Molecular Immunology
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This research was supported by Grants AM-11949 and HL-19421 from the National Institutes of Health to Dr. Weissmann. Dr. Cronstein is a Fellow of the Arthritis Foundation.