Do ANCAs make the difference in lupus nephritis?

There has been much debate as to whether the distinction between lupus nephritis class IV-S and class IV-G is clinically relevant and whether antineutrophil cytoplasmic antibodies are pathomechanistically involved because they have been associated with the more necrotic and pauci-inflammatory phenotype of lupus nephritis that is more often seen in class IV-S. Recent data show that antineutrophil cytoplasmic antibody positivity indeed influences the histological pattern of lupus nephritis and is associated with worse baseline renal function and more active lupus serology.