RT Journal Article
SR Electronic
T1 Clinical phenotype associations with various types of anti-dsDNA antibodies in patients with recent onset of rheumatic symptoms. Results from a multicentre observational study
JF Lupus Science & Medicine
JO Lupus Sci & Med
FD Lupus Foundation of America
SP e000007
DO 10.1136/lupus-2013-000007
VO 1
IS 1
A1 Compagno, Michele
A1 Rekvig, Ole P
A1 Bengtsson, Anders A
A1 Sturfelt, Gunnar
A1 Heegaard, Niels H H
A1 Jönsen, Andreas
A1 Jacobsen, Rasmus Sleimann
A1 Eilertsen, Gro Ø
A1 Fenton, Christopher G
A1 Truedsson, Lennart
A1 Nossent, Johannes C
A1 Jacobsen, Søren
YR 2014
UL http://lupus.bmj.com/content/1/1/e000007.abstract
AB Despite anti-dsDNA antibodies constitute a wide range of specificities, they are considered as the hallmark for systemic lupus erythematosus (SLE). Objective To identify clinical phenotypes associated with anti-dsDNA antibodies, independently of any clinical diagnoses. Methods Patients with recent onset of any rheumatic symptoms were screened for antinuclear antibodies (ANA). All ANA-positive and matching ANA-negative patients were examined, and their clinical phenotypes were registered, using a systematic chart formulated after consensus between the participating centres. All patients were tested for different anti-dsDNA antibody specificities with assays habitually used in each participating laboratory. Crithidia Luciliae Immuno Fluorescence Test (CLIFT) was performed three times (with two different commercial kits); solid and solution phase ELISA were performed four times. Associations between clinical phenotypes and results of anti-dsDNA assays were evaluated by linear regression analysis (LRA) and principal component analysis (PCA). Results Totally, 292 ANA-positive and 292 matching ANA-negative patients were included in the study. A full dataset for statistical analysis was obtained in 547 patients. Anti-dsDNA antibodies were most frequently detected by ELISA. LRA showed that overall positivity of anti-dsDNA antibodies was associated with proteinuria and pleuritis. Alopecia was significantly associated only with CLIFT-positivity. Besides confirming the same findings, PCA showed that combined positivity of CLIFT and ELISA was also associated with lymphopenia. Conclusions Our results show that different anti-dsDNA antibody specificities are associated with nephropathy, pleuritis, alopecia and lymphopenia, regardless of the diagnosis. It may challenge the importance of anti-dsDNA antibodies as a diagnostic hallmark for SLE.