Glaucia V Novak1, Mariana Marques1, Verena Balbi1, Natali W S Gormezano2, Kátia Kozu1, Ana P Sakamoto3, Rosa M R Pereira4, Maria T Terreri3, Claudia S Magalhães5, Andressa Guariento6, Adriana M E Sallum1, Roberto Marini7, Virginia Paes Leme Ferriani8, Cássia Maria Barbosa9, Tânia Caroline Monteiro de Castro10, Valéria C Ramos11, Eloisa Bonfá4, Clovis A Silva12. 1. Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil. 2. Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil; Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil. 3. Pediatric Rheumatology Unit, Universidade Federal de São Paulo, Brazil. 4. Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil. 5. Pediatric Rheumatology Division, São Paulo State University (UNESP) - Faculdade de Medicina de Botucatu, Brazil. 6. Pediatric Rheumatology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, Brazil. 7. Pediatric Rheumatology Unit, State University of Campinas (UNICAMP), Brazil. 8. Pediatric Rheumatology Unit, Ribeirão Preto Medical School - University of São Paulo, Brazil. 9. Pediatric Rheumatology Unit, Hospital Infantil Darcy Vargas, Brazil. 10. Pediatric Rheumatology Unit, Hospital Menino Jesus, Brazil. 11. Pontifical Catholic University of Sorocaba, Brazil. 12. Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo, Brazil; Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil. Electronic address: clovisaasilva@gmail.com.
Abstract
BACKGROUND: To our knowledge there are no studies assessing anti-Ro/SSA and anti-La/SSB autoantibodies in a large population of childhood-systemic lupus erythematosus (cSLE) patients. METHODS: This was a retrospective multicenter cohort study performed in 10 Pediatric Rheumatology services, São Paulo state, Brazil. Anti-Ro/SSA and anti-La/SSB antibodies were measured by enzyme linked immunosorbent assay (ELISA) in 645 cSLE patients. RESULTS: Anti-Ro/SSA and anti-La/SSB antibodies were evidenced in 209/645 (32%) and 102/645 (16%) of cSLE patients, respectively. Analysis of cSLE patients with and without anti-Ro/SSA antibodies revealed higher frequencies of malar rash (79% vs. 71%, p=0.032), photosensitivity (73% vs. 65%, p=0.035), cutaneous vasculitis (43% vs. 35%, p=0.046) and musculoskeletal involvement (82% vs. 75%, p=0.046) in spite of long and comparable disease duration in both groups (4.25 vs. 4.58years, p=0.973). Secondary Sjögren syndrome was observed in only five patients with this antibody (2.5% vs. 0%, p=0.0035), two of them with concomitant anti-La/SSB. The presence of associated autoantibodies: anti-Sm (50% vs. 30%, p<0.0001), anti-RNP (39% vs. 21%, p<0.0001) and anti-ribossomal P protein (46% vs. 21%, p=0.002) was also significantly higher in patients with anti-Ro/SAA antibodies. Further evaluation of cSLE patients with the presence of anti-La/SSB antibodies compared to those without these autoantibodies showed that the frequency of alopecia (70% vs. 51%, p=0.0005), anti-Sm (59% vs. 31%, p<0.0001) and anti-RNP (42% vs. 23%, p<0.0001) were significantly higher in the former group. CONCLUSIONS: Our large multicenter cohort study provided novel evidence in cSLE that anti-Ro/SSA and/or anti-La/SSB antibodies were associated with mild manifestations, particularly cutaneous and musculoskeletal. Secondary Sjögren syndrome was rarely observed in these patients, in spite of comparable frequencies of anti-Ro/SSA and/or anti-La/SSB reported for adult SLE.
BACKGROUND: To our knowledge there are no studies assessing anti-Ro/SSA and anti-La/SSB autoantibodies in a large population of childhood-systemic lupus erythematosus (cSLE) patients. METHODS: This was a retrospective multicenter cohort study performed in 10 Pediatric Rheumatology services, São Paulo state, Brazil. Anti-Ro/SSA and anti-La/SSB antibodies were measured by enzyme linked immunosorbent assay (ELISA) in 645 cSLE patients. RESULTS: Anti-Ro/SSA and anti-La/SSB antibodies were evidenced in 209/645 (32%) and 102/645 (16%) of cSLE patients, respectively. Analysis of cSLE patients with and without anti-Ro/SSA antibodies revealed higher frequencies of malar rash (79% vs. 71%, p=0.032), photosensitivity (73% vs. 65%, p=0.035), cutaneous vasculitis (43% vs. 35%, p=0.046) and musculoskeletal involvement (82% vs. 75%, p=0.046) in spite of long and comparable disease duration in both groups (4.25 vs. 4.58years, p=0.973). Secondary Sjögren syndrome was observed in only five patients with this antibody (2.5% vs. 0%, p=0.0035), two of them with concomitant anti-La/SSB. The presence of associated autoantibodies: anti-Sm (50% vs. 30%, p<0.0001), anti-RNP (39% vs. 21%, p<0.0001) and anti-ribossomal P protein (46% vs. 21%, p=0.002) was also significantly higher in patients with anti-Ro/SAA antibodies. Further evaluation of cSLE patients with the presence of anti-La/SSB antibodies compared to those without these autoantibodies showed that the frequency of alopecia (70% vs. 51%, p=0.0005), anti-Sm (59% vs. 31%, p<0.0001) and anti-RNP (42% vs. 23%, p<0.0001) were significantly higher in the former group. CONCLUSIONS: Our large multicenter cohort study provided novel evidence in cSLE that anti-Ro/SSA and/or anti-La/SSB antibodies were associated with mild manifestations, particularly cutaneous and musculoskeletal. Secondary Sjögren syndrome was rarely observed in these patients, in spite of comparable frequencies of anti-Ro/SSA and/or anti-La/SSB reported for adult SLE.
Authors: Juliana C O A Ferreira; Vitor C Trindade; Graciela Espada; Zoilo Morel; Eloisa Bonfá; Claudia S Magalhães; Clovis Artur Silva Journal: Clin Rheumatol Date: 2018-08-09 Impact factor: 2.980
Authors: Fernanda J Fiorot; Aline G Islabão; Rosa M Pereira; Maria T Terreri; Claudia Saad-Magalhães; Glaucia V Novak; Beatriz C Molinari; Ana P Sakamoto; Nadia E Aikawa; Lucia M Campos; Octavio A Peracchi; Simone Appenzeller; Virgínia P Ferriani; Marco F Silva; Adriana R Fonseca; Flávio R Sztajnbok; Luciana B Paim; Melissa M Fraga; Eunice M Okuda; Blanca E Bica; Evaldo G Sena; Ana J Moraes; Ana M Rolim; Paulo F Spelling; Iloite M Scheibel; André S Cavalcanti; Erica N Matos; Teresa C Robazzi; Luciano J Guimarães; Flávia P Santos; Valeria C Ramos; Magda Carneiro-Sampaio; Eloisa Bonfá; Clovis A Silva Journal: Clin Rheumatol Date: 2019-06-13 Impact factor: 2.980
Authors: Silvia Sirotti; Elena Generali; Angela Ceribelli; Natasa Isailovic; Maria De Santis; Carlo Selmi Journal: Auto Immun Highlights Date: 2017-07-12
Authors: Michaela Butryn; Jens Neumann; Leoni Rolfes; Claudius Bartels; Mike P Wattjes; Nima Mahmoudi; Tabea Seeliger; Franz F Konen; Thea Thiele; Torsten Witte; Sven G Meuth; Thomas Skripuletz; Marc Pawlitzki Journal: J Clin Med Date: 2020-05-14 Impact factor: 4.241