Rheumatology Advance Access originally published online on June 5, 2009
Rheumatology 2009 48(8):953-957; doi:10.1093/rheumatology/kep142
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Clinical and diagnostic value of ribosomal P autoantibodies in systemic lupus erythematosus
1Immunology Laboratory, Habib Bourguiba University Hospital of Sfax, 2Department of Medicine, 3Department of Psychiatry, 4Department of Rheumatology and 5Department of Nephrology, Hédi Chaker University Hospital of Sfax, Sfax, Tunisia.
Correspondence to: Samy Haddouk, Laboratoire d’Immunologie, Chu Habib Bourguiba, 3029 Sfax, Tunisia. E-mail: hadsamy{at}yahoo.fr
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Abstract |
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Objective. To analyse prospectively the diagnostic sensitivity and specificity as well as the clinical relevance of ribosomal P (anti-P) autoantibodies in a large cohort of SLE patients.
Methods. The anti-P autoantibodies were evaluated in the serum of 200 Tunisian SLE patients at disease onset and 130 various control subjects by a sensitive immunodot assay. A complete laboratory evaluation and clinical examination were performed in each SLE patient. During the follow-up, the patients were regularly monitored for clinical parameters. Global SLE activity was measured by the ECLAM.
Results. The sensitivity and specificity of anti-P testing for SLE were 23.5 and 98.4%, respectively. The anti-P-positive samples 14/47 (29.8%), 27/47 (57.4%) and 5/47 (10.6%) were negative for anti-dsDNA, anti-Sm or both antibodies, respectively. The anti-P-positive patients showed more active disease activity and a much higher prevalence of arthritis. An association between IgG aCLs and anti-P antibodies was also found. However, anti-P antibodies were not associated with neuropsychiatric manifestations or lupus nephritis.
Conclusion. This study does not seem to confirm the described association of anti-P antibodies with neuropsychiatric manifestations of SLE. However, it supports the anti-P antibody association with arthritis and disease activity as well as the presence of aCL. Based on our study and other related studies, we propose that, akin to anti-Sm and anti-dsDNA, anti-P antibodies detected by one agreed method may be considered for inclusion as a criterion for the classification of SLE.
KEY WORDS: Anti-ribosomal P antibodies, Systemic lupus erythematosus, Sensitivity, Specificity, Clinical associations
Submitted 26 December 2008;
revised version accepted 24 April 2009.
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