Background/Purpose: Autoantibody targeting Ro52 has been implied as a unique antibody with distinct clinical properties. However, its relations with anti-Ro60 antibody and various connective tissue diseases (CTDs) remain to be elucidated.

Methods: Anti-Ro52 and anti-Ro60 antibodies were determined by immunoblotting test. All those who had positive records of anti-Ro52 in Drum Tower Hospital between January 1, 2016 and September 30, 2017 were included in the analysis. Clinical data of hospitalized patients were extracted through chart review and compared with the difference between Ro52+ Ro60- group and Ro52+ Ro60+ group by using chi-square test.

Results: Totally 4,782 cases were included in this study, among which 3,185 (66.6%) were diagnosis as having CTDs, 1,473 (30.8%) had other diseases and only 124 (2.6%) were healthy. In patients with CTDs, anti-Ro52 was most related to primary Sjögren¡¯s syndrome (pSS), systemic lupus erythematosus (SLE), polymyositis/dermatomyositis and rheumatoid arthritis, while in patients with non-CTDs, anti-Ro52 was often seen in those with respiratory, gastrointestinal, neuropsychiatry and urinary diseases. Compared with Ro52+ Ro60+, Ro52+ Ro60- was more frequent in non-CTD patients (42.5% vs. 12.3%, p < 0.0001). Distribution of Ro52+ Ro60- and Ro52+ Ro60+ in hospitalized CTD patients was showed in Figure 1. For patients with pSS, Ro52+ Ro60- was associated with a low incidence of mucocutaneous, musculoskeletal, gastrointestinal involvement but a high incidence of cardiopulmonary involvement (all p < 0.0001). Meanwhile, SLE patients with Ro52+ Ro60- were found to have less mucocutaneous involvement (p < 0.001) but more cardiopulmonary involvement (p < 0.0001).

Conclusion: Anti-Ro52 is lack of specific in differentiating CTDs from other diseases, especially when it appears alone. In patients with CTDs, the presence of Ro52+ Ro60- may indicate an increase in cardiopulmonary involvement and a decrease in mucocutaneous involvement.