Volume 5, Issue 4, December 2019, Page: 178-182
Autoantibody Profile and Its Association with Clinical Presentation of Paediatric SLE Patients
Kalyan Benjamin Gomes, National Institute of Cardiovascular Disease (NICVD), Dhaka, Bangladesh
Mohammad Imnul Islam, Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Shahana Rahman, Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Received: Jul. 8, 2019;       Accepted: Aug. 12, 2019;       Published: Sep. 9, 2019
DOI: 10.11648/j.ajp.20190504.11      View  18      Downloads  10
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of various auto antibodies including anti-nuclear antibody, double stranded DNA and antibodies to extractable nuclear antigens (ENA), which include four groups of RNA binding protein namely Sm, RNP, SSA/Ro and SSB/La. The objectives were to detect the frequency and pattern of ANA, frequency of anti- ENA antibodies and association between the clinical presentations with ANA and Anti-ENA antibodies in paediatric SLE patients. It was a cross sectional study and the data was collected from patients fulfilling the ACR 1997 revised criteria of SLE in the Department of Paediatrics, BSMMU, Dhaka, Bangladesh. Among 50 paediatric SLE patients, ANA was positive in 94% of the patients. Homogenous pattern of ANA was the highest (57%) followed by speckled (31%), cytoplasmic (6.6%) and nucleolar (3.3%) patterns. Anti-ds DNA positivity was 86% and anti-ENA positivity was 56% in this study. Among them, anti–RNP was found in 43.5% followed by anti-sm (24%), anti-SSA (24%) and anti-SSB (17%). Anti–RNP antibody was associated with renal and gastrointestinal and Anti–SSA was associated with only gastrointestinal manifestations. ANA, anti ds-DNA, anti ENA positivity were found significantly among paediatric SLE patients and clinical presentation of them had association with Anti-ENA antibodies.
Keywords
Extractable Nuclear Antigens (ENA), Systemic Lupus Erythematosus (SLE)
To cite this article
Kalyan Benjamin Gomes, Mohammad Imnul Islam, Shahana Rahman, Autoantibody Profile and Its Association with Clinical Presentation of Paediatric SLE Patients, American Journal of Pediatrics. Vol. 5, No. 4, 2019, pp. 178-182. doi: 10.11648/j.ajp.20190504.11
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40: 1725.
[2]
Egner W. The use of laboratory tests in the diagnosis of SLE. J Clin Pathol 2000; 53: 424-32.
[3]
To CH, Petri M. Is antibody clustering predictive of clinical subsets and damage in systemic lupus erythematosus? Arthritis Rheum 2005; 52: 4003-10.
[4]
Rebecca ES, Stacy PA, Schanberg LE. Systemic Lupus Erythematosus, In Kliegman RM, Stanton BF, St. Geme III JW, Schor NF, Behrman, RE editors. Nelson Textbook of Pediatrics, 1st South Asia Ed. Reed Elsevier, India 2016. pp. 1176-1181.
[5]
Sallai K, Nagy E, DErfalvy B, Muzes G Gergely P. Antinucleosome antibodies and Decreased Deoxyribonuclease Activity in Sere of Patients with Systemic Lupus Erythematosus. Clinical and diagnostic laboratory immunology 2005; 12: 56-59.
[6]
Dipti TR, Azam MS, Sattar MH, Rahman SA. Detection of anti-nuclear antibody by immunofluorescence assay and enzyme immuno assay in childhood systemic lupus erythematosus: experience from Bangladesh. International Journal of Rheumatic Diseases 2012; 15: 121-25.
[7]
Kumar Y, Bhatia A, Minz RW. Antinuclear antibodies and their detection methods in the diagnosis of connective tissue disease: a journey revisited. Diagnostic Pathology 2009; 4: 1 doi: 10.1186/1746-1596-4-1.
[8]
Fritzler MJ. Clinical relevance of autoantibodies in systemic rheumatic diseases. Mol Biol Rep 1996; 23: 133-145.
[9]
Philip HL, Wilfred HSW, Tsz LL, Chak SL, Tak MC, Alexander MHL et al. Relationship between autoantibody clustring and clinical subsets in SLE: cluster and association analyses in Hong Kong Chinese. ’ Rheumatology 2013: 52: 337-345.
[10]
Silverman E, Eddy A. ‘Systemic Lupus Erythematosus’ in Cassidy JT, Petty RE, Laxer RM, Lindsley CB (eds), Textbook of Paediatric Rheumatology 2011, 6th Ed. Philadelphia: Saunders Elsevier, pp. 315-43.
[11]
Yamad A, Gheita T, Darweesh H, klooster P, Gamal R, Faithi H et al. Antibodies to extractable nuclear antigens in systemic lupus erythematosus patients: correlations with clinical manifestations and disease activity. Reumatismo 2018; 70: 85-91.
[12]
Von Mühlen, CA, Tan EM. Autoantibodies in the diagnosis of systemic lupus erythematosus. Semin Arthritis Rheum 1995; 5: 323-58.
[13]
Emlen W, O’Neil L. Clinical significance and interpretation of Anti-nuclear antibodies: comparison of detection with immunofluroscence and enzyme linked immunosorbant assays. Arthris Rheum 1997; 40: 1612-18.
[14]
Kumar S, Nair S, Rajam L. Case series of Pediatric systemic lupuserythematosus from Kerala: comparison with other Indian series. International Journal of Rheumatic Diseases 2010; 13: 391-95.
[15]
Gulay CB, Dans LF. Clinical presentations and outcomes of Filipino juvenile systemic lupus erythematosus. Pediatric Rheumatology 2011; 9: 1-7.
[16]
Rahman SA, Islam MI, Talukder MK, Islam MM, Haque SS, Roy RR. Presentation of childhood Systemic Lupus Erythematosus in a tertiary care hospital. Bangladesh Journal of Child Health 2014; 38: 124-129.
[17]
Kosaraju K, Shenoy S, Suchithra U. A cross- sectional hospital based study of autoantibody profile and clinical manifestations in south Indian patients. Indian Journal of Medical Microbiology 2010; 28: 245-247.
[18]
Liphus BL, Kiss MHB, Goldberg AC. HLA –DRB1 alleles in juvenile onsetsystemic lupus erythmatosus: renal histologic class correlations. Brazillian Journal of Medical and Biological Research 2007; 40: 591-97.
[19]
Dipti TR, Azam MS, Sattar MH, Rahman, SA. Detection of Antinuclear Antibody in Childhood Rheumatic Diseases by Immunofluorescence Assay and Enzyme Immuno Assay. Bangladesh J Child Health 2011; 35: 49-52.
[20]
Weiss JE. Pediatric Systemic Lupus Erythematosus: More than a Positive Antinuclear Antibody. Pediatrics in Review 2012; 33: 62-74.
[21]
Frodlund M, Dahlström Ö, Kastbom A, Skogh T, Sjöwall C. Association between antinuclear antibody staining patterns and clinical features of systemic lupus erythematosus: analysis of a regional Swedish register. BMJ Open 2013; 3: e003608. doi: 10.1136/bmjopen-2013-003608.
[22]
Gonzalez EN, Rothfield NF. Immunoglobulin class and pattern of nuclear fluorescence in systemic lupus erythematosus. New Eng J Med 1966; 274: 1333-1338.
[23]
Migliorini P, Baldini C, Rocci V, Bombardieri S. Anti-Sm and anti-RNP antibodies. Autoimmunity 2005; 38: 47-54.
[24]
Sharmin S, Ahmed S, Sattar H, Miah MRA, Chowdhury MR, Hassan MM Immunofluoresence pattern of Antinuclear Antibody and Its Association with Autoantibody profile in Systemic Lupus Erythematosus. BSMMU J 2013; 6: 141-45.
[25]
Hoffman, IEA, Peene, I, Meheus, L, Huzinga TW J, Cebeacauer L, Isenberg D et al. Specific antinuclear antibodies are associated with clinical features in systemic lupus erythematosus, Ann Rheum Dis 2004; 63: 1155-58.
[26]
Marina M, Melissa F E, Paulo HRN, Thelma LS. Anti RNP in Sytemic lupus Erythematosus. Acta Reumatol Port 2013; 38: 136-37.
[27]
Thompson D, Juby A, Davis P. The clinical significance of autoantibody porofiles in patients with systemic lupus erythematosus. Lupus 1993; 2: 15-19.
[28]
Morasis SA. Isenberg DA. A study of the influence of ethnicity on serology and clinical features in lupus. Lupus 2017; 26:17-26.
Browse journals by subject