ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1308

Antinucleosome Antibodies As Potential Diagnostic and Prognostic Biomarkers in Childhood Onset Systemic Lupus Erythematosus

Thaschawee Arkachaisri1, Joo Guan Yeo2, Justin Hung Tiong Tan3, Sook Fun Hoh4, Lena Das3 and Jing Yao Leong2, 1Rheumatology & Immunology, KK Women's and Children's Hospital, Singapore, Singapore, 2Children Intensive Care Unit (CICU), KK Women's and Children's Hospital, Singapore, Singapore, 3Rheumatology and Immunology, KK Women's and Children's Hospital, Singapore, Singapore, 4Nursing, KK Women's and Children's Hospital, Singapore, Singapore

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: antinucleosome antibodies, Biomarkers, Diagnostic Tests, Juvenile SLE and systemic lupus erythematosus (SLE)

  • Tweet
  • Email
  • Print
Session Information

Session Title: Pediatric Rheumatology - Clinical and Therapeutic Aspects: Pediatric Lupus, Scleroderma and Myositis (ACR)

Session Type: Abstract Submissions (ACR)

Background/Purpose:

The role of antinucleosome antibodies (ANuA) in the immunopathogenesis of SLE is evident. ANuA was shown to be a good, if not better than anti-dsDNA antibody, diagnostic and prognostic biomarkers in adult SLE pts of different ethnicities. Such evidence is scarce in childhood onset SLE (cSLE). We aim to explore the role of ANuA as potential diagnostic and prognostic biomarker in our ASEAN cohort.

Methods:

68 cSLE pts (onset < 18) were recruited and 55 pts with 180 pt-visits with complete clinical data/blood samples were studied. Disease activity (DA) indices: SLEDAI-2K, SLAM and BILAG were recorded. Anti-dsDNA, ANuA (H1-stripped) and anti-C1q were measured by ELISA. Pts were evaluated at 1-3 mo intervals depending on DA. Pts were grouped into 3 DA groups: no activity (ID), minimal DA (MD) = mild DA with no treatment change or DA with improvement from previous visit and active DA (AD) = new case or flare or persistent DA/refractory to treatment. 72 JIA, 6 JDM, 5 MCTD/UCTD, 11 vasculitides, 5 ANA-positive and 17 other inflammatory conditions composed 116 controls (female 45%, median age (IQR) 13.6 (10.3-16.6)). Descriptive statistics were used to describe data. Mann-Whitney/Kruskal-Wallis tests were used to compare data and Spearman's rho for correlation studies.

Results:

55 cSLE (84% female) with median age of 15.9 (14.4-18.2) and median disease duration of 54.7 (29.4-76.2) mo were included. Majority were Chinese and Malay (38%, 33%). Hematologic disorder (98%), arthritis (58%), malar rash (47%) and renal disease (44%) were among most common manifestations. All cSLE had positive ANA at onset. The median (IQR) of SLEDAI-2K, SLAM and BILAG for each disease activity groups were as follows: ID-2.0 (0.0-2.0), 1.0 (0.0-3.0), 1.0 (0.0-1.0); MD-4.0 (3.0-8.0), 3.0 (2.0-4.0), 2.0 (2.0-4.0) and AD-8.0 (4.0-12.0), 6.0 (3.0-9.0), 5.0 (3.0-12.0). ANuA titers among cSLE disease groups and controls were shown in Figure 1. Diagnostic property and correlation studies were shown in Table 1. ANuA level did not fluctuate with renal DA (p=0.601) or associated with the presence of nephritis (p=0.58), so did anti-dsDNA Ab (p=0.587). ANuA showed good and reasonable diagnostic properties, moderate – strong correlations with laboratory parameters but rather weak correlation with DA indices.

 

 

Table 1                        Antinucleosome antibodies (ANuA) as diagnostic biomarkers*

Properties

%

95% confidence interval

Sensitivity

66.67

46.04-83.48

Specificity

100.00

96.87-100.00

+ Likelihood ratio (+LR)

NA as specificity 100.00%, very large

–   Likelihood ratio (-LR)

0.33

0.20-0.57

+ Predictive value (+PPV)

100.00

81.47-100.00

–  Predictive value (-PPV)

92.80

86.77-96.65

Diagnostic odd ratio (DOR)

NA as specificity 100.00%, very large

Antinucleosome antibodies (ANuA) in cSLE and controls

Parameters

cSLE (n=180)ᵟ

Controls (n=116)

ANuA titers (nil < 20 U/ml)

No activity (n=106) ‡

3.57 (2.01-30.63)

1.79 (1.59-1.99)

Minimal activity (n=23) ‡

5.47 (1.83-53.48)

Active disease activity (n=51) ‡

24.14 (2.57-129.64)

ANuA and

Correlation coefficients (rho)

p value

ESR

0.461

<0.001

CRP

0.140

0.065

C3

-0.581

<0.001

C4

-0.479

<0.001

Anti-dsDNA

0.865

<0.001

Anti C1q Ab

0.558

<0.001

SLEDAI

0.338

<0.001

SLAM

0.188

0.012

BILAG

0.074

0.324

*Controls n=116, cSLE n=27 (20 active disease + 7 newly diagnosed)

‡Minimal activity = mild activity with no therapeutic intervention or activity with improvement from previous visit

Active disease activity = New case or flare or persistent activity/ refractory to treatment

ᵟpatient-visits

 

Conclusion:

ANuA has a good diagnostic property with high specificity and high PPV suggesting that it could be a compliment biomarker in cSLE diagnosis. The levels fluctuated with DA with moderate – strong correlation with lab parameters despite weak correlation with clinical index, for which a larger validation study is needed.


Disclosure:

T. Arkachaisri,
None;

J. G. Yeo,
None;

J. H. T. Tan,
None;

S. F. Hoh,
None;

L. Das,
None;

J. Y. Leong,
None.

  • Tweet
  • Email
  • Print

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/antinucleosome-antibodies-as-potential-diagnostic-and-prognostic-biomarkers-in-childhood-onset-systemic-lupus-erythematosus/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences