Cutaneous Lupus Erythematosus Patients with a Negative ANA Meeting Acr and/or SLICC Criteria for Systemic Lupus Erythematosus

Meera Tarazi¹, Carolyn Kushner², Rebecca Gaffney² and Victoria P. Werth³, ¹Department of Dermatology, University of Pennsylvania, Philadelphia, PA, ²Dermatology, University of Pennsylvania, Philadelphia, PA, ³Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ANA, classification criteria and cutaneous lupus erythematosus, SLE

Session Information

Date: Sunday, October 21, 2018

Title: Systemic Lupus Erythematosus – Clinical Poster I: Clinical Manifestations and Comorbidity

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Systemic lupus erythematosus (SLE) is a disorder that is heterogeneous and can be difficult to diagnose. One hallmark of the disease is the presence of anti-nuclear antibodies (ANA), a feature that has been incorporated into multiple classification criteria over the years. In this study, we use a database of cutaneous lupus erythematosus (CLE) patients to determine how many have a negative ANA and meet criteria for SLE using ACR and/or SLICC criteria.

Methods:

We used a database of 454 CLE patients at the University of Pennsylvania that contained information including ANA status and the presence of features of SLE. The database was searched for patients who had a negative ANA and whether or not they met SLE criteria using the ACR and/or SLICC criteria.

Results:

Of the 406 active patients with a known ANA, 147 had a negative ANA (36.2%) and 39 of all patients who had multiple ANAs checked (n = 114) had an ANA that fluctuated (34.2%). 30 ANA negative patients met SLE criteria (20.4%) and 19 patients with fluctuating ANA met SLE criteria (48.7%). Of all patients who had either a negative or a fluctuating ANA and met criteria for SLE (n = 49), 40 patients had involvement of at least 1 organ system other than skin (81.6%), and 22 patients had involvement of at least 2 organ systems other than skin (44.9%). Of the 40 patients with non-mucocutaneous organ involvement, 35 patients had arthritis, 14 patients had leukopenia, 9 patients had renal involvement, 4 patients had serositis, 3 patients had neurologic involvement, and 1 patient had thrombocytopenia.

Conclusion:

Our results demonstrate that a positive ANA is not always present in patients with SLE involving non-mucocutaneous organ systems. If a positive ANA was a requirement for diagnosing SLE, many patients, who warrant treatment or should be included in clinical trials, would be excluded. This should be taken into consideration when devising SLE classification criteria to be used for clinical trials.

Disclosure: M. Tarazi, None; C. Kushner, None; R. Gaffney, None; V. P. Werth, None.

To cite this abstract in AMA style:

Tarazi M, Kushner C, Gaffney R, Werth VP. Cutaneous Lupus Erythematosus Patients with a Negative ANA Meeting Acr and/or SLICC Criteria for Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/cutaneous-lupus-erythematosus-patients-with-a-negative-ana-meeting-acr-and-or-slicc-criteria-for-systemic-lupus-erythematosus/. Accessed .

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