{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:05:39Z","timestamp":1777928739431,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T00:00:00Z","timestamp":1540857600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Cohen Children's Medical Center","award":["Mentored Grant for Early Career Investigators"],"award-info":[{"award-number":["Mentored Grant for Early Career Investigators"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Elevated levels of cell-bound complement activation products (CB-CAPs) (C4d deposition on B lymphocytes (BC4d) and\/or erythrocytes (EC4d)) are sensitive and specific in diagnosis and monitoring of adult systemic lupus erythematosus (SLE). Our objective was to evaluate the role of CB-CAPs for diagnosis and monitoring of pediatric-onset SLE (pSLE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study of 28 pSLE and 22 juvenile arthritis patients was conducted. SLE disease activity was determined using a clinical Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) that excluded serologies. Autoantibodies were measured using solid-phase immunoassays, C3 and C4 using immunoturbidimetry, and CB-CAPs using quantitative flow cytometry. Abnormal CB-CAPs were defined as EC4d or BC4d above the 99th percentile for healthy adults (&gt;14 and\u2009&gt;\u200960 net mean fluorescence intensity (MFI), respectively). Performance characteristics of CB-CAPs were assessed using area under the curve (AUC) for receiver operating characteristics. Linear mixed effect models evaluated the correlation between CB-CAPs and clinical SLEDAI over 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>BC4d yielded higher AUC (0.91\u2009\u00b1\u20090.04) than C3 (0.63\u2009\u00b1\u20090.08) and C4 (0.67\u2009\u00b1\u20090.08) ( p\u2009&lt;\u20090.05). Abnormal CB-CAPs were 78% sensitive and 86% specific for diagnosis of pSLE (Youden\u2019s index\u2009=\u20090.64\u2009\u00b1\u20090.11). In contrast to BC4d, EC4d levels correlated with clinical SLEDAI ( p\u2009&lt;\u20090.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CB-CAPs (EC4d and BC4d) have higher sensitivity and specificity than low complement in pSLE, and may help with diagnosis of pSLE. EC4d could provide a useful biomarker for disease activity monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0961203318809181","type":"journal-article","created":{"date-parts":[[2018,10,31]],"date-time":"2018-10-31T01:33:40Z","timestamp":1540949620000},"page":"2262-2268","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Cell-bound complement activation products (CB-CAPs) have high sensitivity and specificity in pediatric-onset systemic lupus erythematosus and correlate with disease activity"],"prefix":"10.1177","volume":"27","author":[{"given":"J S","family":"Hui-Yuen","sequence":"first","affiliation":[{"name":"Division of Pediatric Rheumatology, Steven and Alexandra Cohen Children\u2019s Medical Center of New York, Lake Success, New York, USA"},{"name":"Department of Pediatrics, Hofstra Northwell School of Medicine, Hempstead, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Gartshteyn","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Columbia University Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Ma","sequence":"additional","affiliation":[{"name":"Division of Pediatric Rheumatology, Steven and Alexandra Cohen Children\u2019s Medical Center of New York, Lake Success, New York, USA"},{"name":"Department of Pediatrics, Hofstra Northwell School of Medicine, Hempstead, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"O\u2019Malley","sequence":"additional","affiliation":[{"name":"Exagen Diagnostics, Vista, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Conklin","sequence":"additional","affiliation":[{"name":"Exagen Diagnostics, Vista, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A H","family":"Eichenfield","sequence":"additional","affiliation":[{"name":"Division of Pediatric Rheumatology, Columbia University Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L F","family":"Imundo","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Columbia University Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Dervieux","sequence":"additional","affiliation":[{"name":"Exagen Diagnostics, Vista, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A D","family":"Askanase","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Columbia University Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,10,30]]},"reference":[{"key":"bibr1-0961203318809181","doi-asserted-by":"publisher","DOI":"10.1177\/0961203311412096"},{"key":"bibr2-0961203318809181","doi-asserted-by":"publisher","DOI":"10.1177\/0961203311403022"},{"key":"bibr3-0961203318809181","doi-asserted-by":"publisher","DOI":"10.1002\/art.23204"},{"key":"bibr4-0961203318809181","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2010.04.005"},{"key":"bibr5-0961203318809181","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh719"},{"key":"bibr6-0961203318809181","doi-asserted-by":"publisher","DOI":"10.1136\/ard.48.7.600"},{"key":"bibr7-0961203318809181","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780350907"},{"key":"bibr8-0961203318809181","volume":"67","author":"Conklin J","year":"2015","journal-title":"Arthritis 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