This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Kremer Hovinga, I. Search for Related Content PubMed PubMed Citation Articles by Kremer Hovinga, I. Social Bookmarking                         What's this?

Pregnancy, chimerism and lupus nephritis: a multi-centre study

Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands

M Koopmans

Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands

C Grootscholten

Department of Nephrology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands

AM van der Wal

Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands

M Bijl

Department of Clinical Immunology, University Medical Center Groningen, Groningen, the Netherlands

RHWM Derksen

Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, the Netherlands

AE Voskuyl

Department of Rheumatology, VU University Medical Center, Amsterdam, the Netherlands

E de Heer

Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands

JA Bruijn

Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands

JHM Berden

Department of Nephrology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands

IM Bajema

Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands

on behalf of the Dutch Working Party on Systemic Lupus Erythematosus

Chimerism occurs twice as often in the kidneys of women with lupus nephritis as in normal kidneys and may be involved in the pathogenesis of systemic lupus erythematosus. Pregnancy is considered the most important source of chimerism, but the exact relationship between pregnancy, the persistence of chimeric cells and the development of systemic lupus erythematosus has not been investigated. Renal biopsies and clinical data from patients in the First Dutch Lupus Nephritis Study were used. Chimeric cells were identified by in-situ hybridization of the Y chromosome. A questionnaire was used to obtain detailed reproductive data including pregnancy history and miscarriages. Chimerism was found in 12 of 26 (46%) renal biopsies. Of the 12 chimeric women, 5 reported a pregnancy; of 14 women who were not chimeric, 8 reported a pregnancy. Chimeric women who had been pregnant reported significantly more pregnancies than non-chimeric women who had been pregnant (P = 0.04). The median age of the youngest child was higher in chimeric women (19 years) than in non-chimeric women (6 years). Despite the attention given to pregnancy histories with respect to chimerism, this study shows that in patients with systemic lupus erythematosus, a clear-cut relationship is not apparent. A considerable number of chimeric women did not report a pregnancy: in these women, other sources of chimerism must be considered. Our data support the theory that only certain subsets of chimeric cells persist into the maternal circulation after pregnancy.

Key Words: lupus nephritis • microchimerism • pregnancy • kidney

Lupus, Vol. 17, No. 6, 541-547 (2008)
DOI: 10.1177/0961203308089324


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?