Article Text
Abstract
Background/Purpose In Systemic Lupus Erythematosus (SLE) the presence of some autoantibodies is related to specific clinical manifestations. We aimed to define SLE patient groups according to an autoantibody profile and to analyze the correlation of these profiles to clinical manifestations.
Methods A cross-sectional observational study of SLE (SLICC 2012 criteria) was conducted. A clinical and analytical evaluation was performed. Clinical manifestations were described according to RELESSER study.
We selected 8 autoantibodies to classify SLE patients: anti-dsDNA, anti-Sm, anti-RNP, anticardiolipin IgG/IgM (aCL IgG/M), anti-ß2microglobulin IgG/IgM (aß2M IgG/M), lupus anticoagulant (LA), anti-Ro and anti-La. Immunological profiles were created according to previous study of Artim-Esen B et al. 2014.
Results 142 SLE patients with a mean age at diagnosis of 33.29 (13.53) and a mean time of disease evolution of 15.82 (10.56) years were evaluated. Mean SLEDAI score was 5.91 (5.6) and mean SLICC value 1.1 (1.46). Autoantibody frequencies are: ANAs 87.3%, anti-dsDNA 36.62%, anti-Sm 9.2%, anti-RNP 3.5%, aCL IgG/M 20.15%, aß2M IgG/M 21.88%, LA 26.27%, anti-Ro 45.07% and anti-La 16.2%.
Profile n°2 included SLE patients with anti-Sm/RNP positivity. Profile n°3 included patients with anti-Ro/La positivity. Profile n°4 included patients with aCL IgG/M or aB2M IgG/M or LA positivity. Profile n°5 included patients who exclusively showed anti-DNA positivity. Profile n°1 included all patients excluded from the other profiles.
Profile n°1 patients were diagnosed earlier and had a longer disease evolution, whereas Profile n°5 patients were diagnosed later and with shorter disease evolution.
We observed a significant association among hematological affection and high levels of anti-Ro (P<0.0001), anti-La (P=0.022) and anti-Sm (P=0.018) was observed.
Conclusions An association between the presence of anti-Ro/La and hematological affection, as well as high incidence of Sjögren syndrome in these subgroup of patients was described.