Objective       To investigate the clinicopathological features and outcomes of lupus nephritis (LN) with being positive to anti-neutrophil cytoplasmic antibodies (ANCA).       Methods       Clinical data of 154 patients with LN who underwent renal biopsy in our department from January 2011 to December 2013 were collected and analyzed retrospectively. According to the results of EUROBlot and indirect immunofluorescence staining

the patients were divided into 2 groups. ANCA-positive and ANCA-negative. The clinical manifestations

laboratory examinations results

pathologic features

systemic lupus erythematosus disease activity index (SLEDAI) and prognosis were compared between ANCA-positive and ANCA-negative groups.       Results      Among all the patients presented in this study

there were 26 patients (16.88%) positive to ANCA [including 24 cases positive to myeloperoxidase (MPO)-ANCA and 2 cases positive to proteinase 3 (PR3)-ANCA]

and 128 LN patients negative to ANCA. The incidences of alopecia

oral ulcer

photosensitivity and skin lesion were obviously higher in the positive group than the negative one (P0.007

0.016

0.022). So were the frequencies of being positive to anti-nucleosome antibody and anti-cardiolipin antibody (P0.001

0.005). But the level of C3 was significant lower in the former than the latter groups (P=0.034). The incidence and percentage of glomerular sclerosis and chronic index (CI) were higher in positive group than the negative group (P0.003

0.004

0.013). There were no significant differences in pathological types

activity index (AI)

tubular interstitial lesion (TIL)

SLEDAI

and severities of crescent formation

vascular loop necrosis

micro thrombosis

renal tubular atrophy and renal interstitial fibrosis between the 2 groups (P0.05). The mortality showed no significant difference either (P0.05). The negative conversion rate of proteinuria was obviously lower in the positive than the negative groups (Chi square=7.421

P=0.006).       Conclusion       Alopecia

oral ulcer

photosensitivity and skin lesion are more common in LN patients with positive ANCA. They also have worse renal pathological degree of reversibility and poorly outcomes. So the patients need to be treated as early as possible.