Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Anti-Ro/SSA and anti-La/SSB antibodies were reported in 30-50% and 10-30% of adult SLE patients, associated mainly with cutaneous manifestations. However, to our knowledge there are no studies assessing these autoantibodies in a large population of childhood SLE (cSLE) patients. Therefore, the aim of this multicenter cohort study was to evaluate demographic, clinical and laboratorial features in cSLE patients with and without the presence of anti-Ro/SSA and anti-La/SSB antibodies.
Methods: This was a retrospective multicenter study performed in 10 Pediatric Rheumatology services of São Paulo state, Brazil. Anti-SSA/Ro and anti-SSB/La antibodies were measured by either contraimmunoelectrophoresis or enzyme linked immuno sorbent assay (ELISA) in 645 patients cSLE patients. Other autoantibody analysis was performed according to the routine laboratory of each Center. Demographic data, cumulative clinical and laboratorial features and disease damage (SLICC/ACR-DI) at last visit were evaluated. Juvenile Sjögren’s syndrome was established according to the American-European Consensus Group.
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), musculoskeletal involvement (82% vs. 75%, p=0.046) in spite of long and comparable disease duration in both groups (4.25 vs. 4.58 years, p=0.973). Sjögren syndrome was rare and 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) were also significantly higher in patients with the presence of anti-Ro/SAA antibodies. Female gender, multi-organ involvement and SLICC/ACR-DI, including skin damage, were similar in both groups (p>0.05). 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), anti-RNP (42% vs. 23%, p<0.0001) were significantly higher in the former group. Further evaluation of cSLE patients with and without concomitant anti-Ro/SSA and anti-La/SSB antibodies showed a lower frequency of anti-dsDNA (55% vs. 70%, p=0.009), whereas alopecia (71% vs. 51%, p=0.0008), anti-Sm (59% vs. 29%, p=0.0001) and anti-RNP (45% vs. 21%, p=0.0001) were more frequent in patients with these antibodies.
Conclusion: Our large multicenter 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. Sjögren syndrome was rarely diagnosed in these patients, in spite of the comparable frequencies of anti-Ro/SSA and/or anti-La/SSB reported for adult SLE.
To cite this abstract in AMA style:Novak GV, Marques M, Balbi V, Gormezano NW, Kozu KT, Sakamoto AP, Pereira RMR, Terreri MT, Magalhães CS, Sacchetti SB Sr., Sallum AME, Marini R Sr., Ferriani V, Barbosa CM, Castro TCM, Ramos VC, Bonfá E, Silva CA. ANTI-RO/SSA and/or ANTI-La/SSB Antibodies: Association with Mild LUPUS Manifestations in 645 Childhood-Onset Systemic LUPUS Erythematosus [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/anti-rossa-andor-anti-lassb-antibodies-association-with-mild-lupus-manifestations-in-645-childhood-onset-systemic-lupus-erythematosus/. Accessed October 15, 2021.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/anti-rossa-andor-anti-lassb-antibodies-association-with-mild-lupus-manifestations-in-645-childhood-onset-systemic-lupus-erythematosus/