Background and aims Systemic Lupus Erythematosus (SLE) is known for its multifaceted clinical features and complex immune disturbance. Numerous studies have proven that certain autoantibodies are linked to specific clinical manifestations. However, the diversity of possible associations makes for the uniqueness of each case of SLE. The goal of our study was to analyse the link between clinical presentation and autoantibody titers in Romanian patients with SLE.

Methods We conducted an observational study of 48 adult patients with SLE hospitalised in the Rheumatology Department of the Clinical Rehabilitation Hospital. Venous blood samples were drawn to measure antinuclear antibody levels as well as anti-dsDNA, anti-ssDNA, anti-Sm, anti-U1RNP, anti-SSA, anti-SSB and anti-nucleosome antibody titers (ELISA). Clinical presentation, biochemical tests, SLEDAI score values and urinalysis were extracted from patients‘ charts. Patient characteristics were included in a database and analysed using IBM SPSS Statistics v20.

Results We found statistically significant correlations (p<0.05) between cutaneous manifestations and anti-Sm, anti-U1RNP, anti-SSA, anti-SSB and anti-nucleosome antibodies. Kidney involvement correlated with anti-Sm, anti-U1RNP and anti-nucleosome antibodies (p<0.05). Joint involvement was strongly associated with the presence of anti-U1RNP antibodies (p=0.001). Haematological abnormalities were significantly correlated with anti-dsDNA, anti-U1RNP, anti-SSA and anti-SSB antibodies (p<0.05), while ESR and CRP levels were only associated with anti-U1RNP antibodies (p=0.03). Furthermore, SLEDAI scores correlated with anti-dsDNA and anti-nucleosome antibody titers (p<0.05).

Conclusions Our data support the relationship between autoantibody titers, disease activity and severity of clinical changes in Romanian patients with systemic lupus erythematosus.