High anti-golgi autoantibody levels: an early sign of autoimmune disease?

IgG anti-Golgi complex antibodies were detected by means of indirect immunofluorescence in the sera of five patients during routine investigation for suspected systemic autoimmune disease. The typical picture of paranuclear fluorescence was observed on the HEp-2 cell line and in tissue sections; anti-Golgi specificity was confirmed on the HEp-2 cells using the immunoperoxidase method. The phenomenon was transient in three patients with a probable viral infection and whose sera had low titre antibodies; however, it was persistent and in high concentration in the other two who, five years later, developed an autoimmune disease. Only in the sera of these last two patients were specific bands of 123, 72, 46, 37 and 26 kilodaltons found by the immunoblotting technique on cytoplasmic extracts. Although the detection of anti-Golgi autoantibodies is rare, and may represent a transitory epiphenomenon in patients with a viral infection, their presence in high titre in the absence of a clear clinical picture may constitute an early sign of systemic autoimmune disease.