Rheumatology 2002; 41: 1357-1366
© 2002 British Society for Rheumatology
Original Papers |
Clinical and serological associations of ribosomal P autoantibodies in systemic lupus erythematosus: prospective evaluation in a large cohort of Italian patients
Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Perugia,
1 Laboratory of Specialised Clinical Analysis, University of Pisa,
2 Clinical Immunology, University of Brescia,
3 Clinical Immunology, University of Milano,
4 Clinical Immunology and Rheumatology Unit, Vita-Salute S. Raffaele University, Milano,
5 Institute of Internal Medicine, University of Ancona,
6 Medical Oncology Service, A.S.L. 2, Perugia,
7 Clinical Psychology and Psychiatry, University of Perugia,
8 Division of Neurology, University of Brescia,
9 Department of Neuropsychiatric Science, Vita-Salute S. Raffaele University, Milano and
10 Rheumatology Unit, University of Pisa, Italy
Objective. To verify the association of ribosomal anti-P antibodies (anti-P), as detected by a sensitive ELISA, with serological findings and clinical manifestations, including neuropsychiatric involvement evaluated according to the American College of Rheumatology (ACR) nomenclature, in a large cohort of patients with systemic lupus erythematosus (SLE).
Methods. Anti-P were evaluated in the serum of 149 consecutive Italian SLE patients by an ELISA using a multiple antigen peptide carrying four copies of a common P0, P1 and P2 epitope. A complete laboratory evaluation and clinical examination were performed in each patient. In addition, all patients underwent an accurate neuropsychiatric and neuropsychological assessment performed by trained specialists according to the 1999 ACR suggestions.
Results. Serum anti-P were detected in 18/149 patients (12.1%). The anti-P prevalence was similar (11.7%) when the analysis was performed in a larger series of sera including 82 additional SLE patients, who were not included in the clinical study. The age of anti-P-positive patients at disease onset was less than 33 yr and, in comparison with the anti-P-negative patients, these patients showed more active disease activity and a higher prevalence of photosensitivity and malar and discoid rash. A strong association between IgG anticardiolipin antibodies and anti-P was also found. However, anti-P were associated with neither neuropsychiatric syndromes nor cognitive impairment.
Conclusion. This study does not seem to confirm the described association of anti-P with SLE neuropsychiatric manifestations. However, it supports the anti-P association with different skin manifestations as well as the presence of anticardiolipin in a subset of patients with SLE characterized by early disease onset.
KEY WORDS: Anti-P antibodies, Systemic lupus erythematosus, Anticardiolipin antibodies, Neuropsychiatric lupus.
Correspondence to: R. Gerli, Centro per lo Studio delle Malattie Reumatiche, Sezione di Medicina Interna e Scienze Oncologiche, Policlinico Monteluce, I-06122 Perugia, Italy.
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