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Lupus. 2017 Apr;26(5):484-489. doi: 10.1177/0961203316676386.

Anti-ribosomal P antibody: a multicenter study in childhood-onset systemic lupus erythematosus patients.

Author information

1
1 Pediatric Rheumatology Unit, Children's Institute, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Brazil.
2
2 Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Brazil.
3
3 Pediatric Rheumatology Unit, State University of Campinas (UNICAMP), Brazil.
4
4 Pediatric Rheumatology Unit, Universidade Federal de São Paulo (UNIFESP), Brazil.
5
5 Pediatric Rheumatology Division, São Paulo State University (UNESP) - Faculdade de Medicina de Botucatu, Brazil.
6
6 Pediatric Rheumatology Unit, Hospital Darcy Vargas, Brazil.
7
7 Pediatric Rheumatology Unit, Ribeirão Preto Medical School - FMUSP, Brazil.

Abstract

Objectives Anti-ribosomal P protein (anti-P) autoantibodies are highly specific for systemic lupus erythematosus (SLE). However, the evaluation of this autoantibody in childhood-onset SLE (cSLE) populations has been limited to a few small series, hampering the interpretation of the clinical and laboratorial associations. Therefore, the objective of this multicenter cohort study was to evaluate demographic, clinical/laboratorial features, and disease damage score in cSLE patients with and without the presence of anti-P antibody. Methods This was a retrospective multicenter study performed in 10 pediatric rheumatology services of São Paulo state, Brazil. Anti-P antibodies were measured by ELISA in 228 cSLE patients. Results Anti-P antibodies were observed in 61/228 (27%) cSLE patients. Frequencies of cumulative lymphadenopathy (29% vs. 15%, p = 0.014), acute confusional state (13% vs. 5%, p = 0.041), mood disorder (18% vs. 8%, p = 0.041), autoimmune hemolytic anemia (34% vs. 15%, p = 0.001), as well as presence of anti-Sm (67% vs. 40%, p = 0.001), anti-RNP (39% vs. 21%, p = 0.012) and anti-Ro/SSA antibodies (43% vs. 25%, p = 0.016) were significantly higher in cSLE patients with anti-P antibodies compared to those without these autoantibodies. A multiple regression model revealed that anti-P antibodies were associated with autoimmune hemolytic anemia (odds ratio (OR) = 2.758, 95% confidence interval (CI): 1.304-5.833, p = 0.008) and anti-Sm antibody (OR = 2.719, 95% CI: 1.365-5.418, p = 0.004). The SLICC/ACR damage index was comparable in patients with and without anti-P antibodies ( p = 0.780). Conclusions The novel association of anti-P antibodies and autoimmune hemolytic anemia was evidenced in cSLE patients and further studies are necessary to determine if anti-P titers may vary with this hematological manifestation.

KEYWORDS:

Systemic lupus erythematosus; anti- ribosomal P protein antibodies; autoimmune hemolytic anemia; childhood; neuropsychiatric lupus

PMID:
28394238
DOI:
10.1177/0961203316676386
[Indexed for MEDLINE]

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