Lupus最新文献

{"title":"Real world use of belimumab in patients with lupus nephritis.","authors":"Luxme Nadarajah, Cameron Bonthrone, Angela Pakozdi, Debasish Pyne, Andrea Cove-Smith, Ravindra Rajakariar","doi":"10.1177/09612033251325297","DOIUrl":"https://doi.org/10.1177/09612033251325297","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251325297"},"PeriodicalIF":1.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of anti-ribosomal P protein antibodies in systemic lupus erythematosus: A single-center retrospective study in China.","authors":"Jinlu Ma, Lin Zhang, Mengxue Yan, Cui Lu, Leixi Xue","doi":"10.1177/09612033251324467","DOIUrl":"https://doi.org/10.1177/09612033251324467","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the clinical characteristics of patients with systemic lupus erythematosus (SLE) with positive anti-ribosomal P protein antibodies and the associated risk factors in a larger sample size.</p><p><strong>Methods: </strong>A single-center, retrospective study was conducted. Based on the medical records of in-patients from June 2009 to December 2022, patients with SLE were divided into anti-ribosomal P protein antibody-positive and negative groups according to a 1:3 gender and age match.</p><p><strong>Results: </strong>This study included 388 patients with SLE, of which 97 (25%) and 291 (75%) were positive and negative for anti-ribosomal P protein antibodies, respectively. The median age of all patients was 35.0 (27.0-48.0) years, and 89.9% were female. The result showed that compared with the patients with anti-ribosomal P protein antibody-negative SLE, those who were positive had lower C3 and C4 levels, more frequent comorbid rashes, and higher disease activity; in terms of autoantibodies, the anti-ribosomal P protein antibodies correlated with anti-Smith and anti-U1RNP antibodies. The result also showed that low C3 levels, anti-U1RNP antibody positivity, and rash are independent risk factors for anti-ribosomal P protein antibody positivity in patients with SLE.</p><p><strong>Conclusion: </strong>Anti-ribosomal P protein antibody-positive SLE is characterized by high disease activity; low C3 levels, anti-U1RNP antibody positivity and rashes are independent risk factors for anti-P antibody positivity in SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251324467"},"PeriodicalIF":1.9,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illness perception and psychological distress in adolescents with systemic lupus erythematosus.","authors":"Navaporn Tangkittiwet, Sirirat Charuvanij, Boonying Manaboriboon, Sasitorn Chantaratin, Anirut Pattaragarn, Nuntawan Piyaphanee","doi":"10.1177/09612033251325313","DOIUrl":"https://doi.org/10.1177/09612033251325313","url":null,"abstract":"<p><strong>Background: </strong>The illness perception and mental health in Systemic Lupus Erythematosus (SLE) is acknowledged. However, the link between illness perceptions and psychological issues in adolescents with SLE remains unclear. This study aims to assess the relationships between illness perception and depressive symptoms, anxiety, fatigue, pain, and sleep quality, as well as to identify factors associated with negative illness perception.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with adolescents aged 12-18 years diagnosed with SLE during a clinic visit. Personal information was collected through a self-report questionnaire. Illness perception was assessed using Brief Illness Perception Questionnaire (B-IPQ), while psychological impact was evaluated using Patient Health Questionnaire for Adolescents (PHQ-A) and Generalized Anxiety Disorders Scale (GAD-7). PedsQL Multidimensional Fatigue Scale, Visual Analogue Scale of Pain (VAS-P), and Pittsburgh Sleep Quality Index (PSQI) were used to assess fatigue, pain, and sleep quality, respectively. Disease activity was measured by the Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index (SELENA-SLEDAI) and Physician Global Assessment (PGA), while organ damage was assessed using the SLICC/ACR Damage Index (SDI). The correlations between these measures were analyzed, and multivariable regression analysis was conducted to identify associated factors.</p><p><strong>Results: </strong>The study included 102 patients, with a mean age of 15.2 ± 1.7 years, of whom 94.1% were female. Depressive symptoms (PHQ-A ≥5), anxiety (GAD-7 ≥7), pain (VAS-P > 3), and poor sleep quality (PSQI>5) were observed in 31.4%, 14.7%, 14.7%, and 29.4% of the patients, respectively. Within B-IPQ items, the timeline was perceived most negatively, while treatment control was perceived most positively. Negative illness perception moderately correlated with depressive symptoms (r = 0.487), anxiety (r = 0.459), and fatigue (r = 0.493), weakly correlated with pain (r = 0.334), sleep quality (r = 0.355) and PGA (r = 0.255), and no correlation with SELENA-SLEDAI and SDI. A self-reported poor relationship with friends (B coefficient 9.12, 95%CI: 3.22-15.01, <i>p</i> = .003) and a PGA score of 0.5 or higher (8.61, 3.52-13.69, <i>p</i> = .001) were associated with negative illness perception.</p><p><strong>Conclusions: </strong>Psychological distress including depressive symptoms, anxiety, fatigue, pain, and sleep quality significantly correlated to illness perception in adolescent SLE. Further research is required to investigate the effects of illness perception on patient adherence and outcomes.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251325313"},"PeriodicalIF":1.9,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum CXCL-13 levels are associated with active neurological involvement in patients with systemic lupus erythematosus.","authors":"Derya Yildirim, Abdulsamet Erden, Antonis Fanouriakis, Handenur Koc Kanik, Hakan Babaoglu, Riza Can Kardas, Burcugul Kaya, Ibrahim Vasi, Rahime Duran, Hazan Karadeniz, Hamit Kucuk, Berna Goker, Mehmet Akif Ozturk, Abdurrahman Tufan","doi":"10.1177/09612033251319405","DOIUrl":"10.1177/09612033251319405","url":null,"abstract":"<p><p><b>Background:</b> Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse systemic manifestations, including neuropsychiatric involvement (NPSLE), which can vary in severity and prognosis. Diagnosing NPSLE remains challenging, necessitating reliable diagnostic markers. CXCL13, a B-cell chemokine implicated in SLE, has garnered attention for its potential role in NPSLE.<b>Purpose:</b> This study aimed to assess serum CXCL-13 levels in NPSLE patients compared to SLE patients without neuropsychiatric symptoms and healthy controls.<b>Research Design:</b> All study groups were studied CXCL-13 levels from blood samples.<b>Study Sample:</b> One hundred twenty-five participants were categorized into four groups: SLE patients with active NPSLE (<i>n</i> = 6), SLE patients with inactive NPSLE (<i>n</i> = 26), SLE patients without NPSLE (<i>n</i> = 71), and healthy controls (<i>n</i> = 22).<b>Data Collection and Analyses:</b> Serum samples were collected at the time of enrollment and CXCL-13 levels were analysed by Enzyme Linked ImmunoSorbent Assay (ELISA) method.<b>Results:</b> Results indicated significantly elevated CXCL-13 levels in active NPSLE patients compared to other SLE patient groups and healthy controls (<i>p</i> < 0.001 for all). Patients with SLE, including those with inactive NPSLE or no history of NPSLE, had statistically significantly higher serum CXCL-13 levels compared to the control group (<i>p</i> < 0.001). Additionally, serum CXCL-13 levels positively correlated with disease activity assessed by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI).<b>Conclusion:</b> This study underscores the association between serum CXCL-13 levels and neuropsychiatric involvement in SLE, as well as their correlation with disease activity. Moreover, previous research suggesting a link between CXCL-13 levels and clinical activity in SLE further supports its potential as a diagnostic marker for NPSLE. Nevertheless, further investigations are warranted to validate the utility of CXCL-13 as a diagnostic tool for NPSLE and its role in disease management.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"281-291"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of white matter brain lesions on processing speed deficits in systemic lupus erythematosus patients.","authors":"Anna Wójcicka-Frankiewicz, Mikołaj A Pawlak, Maciej Piernik, Maria Forycka, Monika Wiłkość-Dębczyńska, Ewa Więsik-Szewczyk, Katarzyna Pawlak-Buś, Piotr Leszczyński, Sławomir Michalak, Aleksandra Wypych, Zbigniew Serafin, Wojciech Kozubski, Alicja Kalinowska-Łyszczarz","doi":"10.1177/09612033251319826","DOIUrl":"10.1177/09612033251319826","url":null,"abstract":"<p><p>BackgroundThe mechanism of cognitive dysfunction in systemic lupus erythematosus (SLE) is still not fully understood. Even though many SLE patients present some neurological dysfunction, including various cognitive deficits, neither a specific pattern of cognitive dysfunction nor specific structural changes associated with cognitive impairment in SLE patients have been established. Moreover, although prevalent and bothersome, cognitive deficits have not been included in the most recent SLE diagnostic criteria.PurposeThe aim of this study was to determine the relationship between the presence of white matter lesions (WMLs) and cognitive dysfunction in patients diagnosed with SLE.Research Design33 SLE patients underwent 3 T brain magnetic resonance imagining (MRI) and an extensive battery of psychological tests, including Automated Neuropsychological Assessment Metrics (ANAM) and the standard pen and paper neuropsychological tests. Patients were stratified into two groups based on the presence (<i>N</i> = 15) or absence (<i>N</i> = 18) of WMLs. Psychometric scores were compared between the two groups.Results and conclusionsSignificant deficits in cognitive functions were observed. Patients with WMLs showed deficits in attention and executive functions, as well as memory deficits in comparison to the group without WMLs. As measured with: STROOP Test (executive function), Color Trail Test (CTT) (attention), Californian Verbal Learning Test (CVLT) (memory), and from ANAM tests with: Procedural Reaction Time (PRT) (attention), Code Substitution Delayed (CS_D) (memory), Spatial Processing (SP) (visuospatial functions), Tower Puzzle (TP) (executive functions), 2 Choice Reaction Time (2CHRT) (attention), Running Memory CPT (RM CPT) (memory), Matching Grids (Mat GR) (visuospatial functions), Go/No _Go inhibition (Go/No_Go Go) (executive functions). Additionally, we analyzed structural volumetric measures derived from a comprehensive segmentation pipeline recon-all using Freesurfer 5.3. Significant differences were identified for the following structures' volumes: right choroid plexus, left choroid plexus, right lateral ventricle. All these structures had a greater volume in patients with WMLs.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"270-280"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic literature review of intravenous immunoglobulin use in non-renal and non-hematologic systemic lupus erytehmatosus.","authors":"Cristina Primo-Gabriel, Carmen García-Gómez, Jaime Calvo-Alén","doi":"10.1177/09612033251319402","DOIUrl":"10.1177/09612033251319402","url":null,"abstract":"<p><p><b>Objective</b>: Intravenous immunoglobulins (IVIG) are an established treatment in several immune-mediated diseases such as dermatomyositis or Kawasaki disease and they have been used in distinct clinical scenarios in systemic lupus erythematosus (SLE). However, in this latter disease no clear evidence besides hematological or renal involvement supports its use. The aim of the present study is to establish evidence for the treatment of non-renal non-hematological lupus with IVIG.<b>Methods</b>: We have carried out a systematic literature review following PRYSMA principles on the use of this treatment in SLE patients with no renal no hematologic manifestations.<b>Results</b>: We found 35 articles which were split into two subtypes, those with individualized data (29) and those with grouped data. Overall, 198 lupus patients treated with IVIGs [178 (90%) women and 20 (10%) men] were included. In 167 (84.3%) a clinical response was obtained [62 (31.3%) complete and 105 (53%) a partial one]. Adverse events were reported in 40 patients (20.2%), most of them mild with only 2 (1%) severe. According to individualized data, all cases with respiratory problems (5), 82.4% of those with cardiac involvement (18) and 53.8% of those with neuropsychiatric manifestations (18) achieved a complete response as more outstanding results.<b>Conclusions</b>: After reviewing the experience of the use of IVIGs in extra-renal and extra-hematologic SLE patients, this treatment is demonstrated to be useful in refractory cases, especially in pulmonary, cardiac or neuropsychiatric complications with a good safety profile.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"261-269"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nocardiosis in systemic lupus erythematosus patients treated with rituximab: Report of two cases and systematic review of literature.","authors":"Jaime Gil-Rodríguez, Javier de la Hera Fernández, Michel Martos Ruiz, Raquel Ríos Fernández, Marta García Morales, José-Luis Callejas-Rubio","doi":"10.1177/09612033251319836","DOIUrl":"10.1177/09612033251319836","url":null,"abstract":"<p><p>BackgroundThe relationship between systemic lupus erythematosus (SLE) patients treated with rituximab and nocardiosis remains unclear.Cases ReportA 55-year-old female with lupus nephritis II and smoking history, was treated with high-dose steroids, immunoglobulins, rituximab, and azathioprine. She developed infectious loci in the lungs, hip, and brain. N. farcinica was detected in bronchoalveolar lavage and abscess culture. She was treated with linezolid, trimethoprim/sulfamethoxazole (TMP/SMX), minocycline, and amoxicillin/clavulanic acid, achieving complete cure at 12 months. The second patient, a 73-year-old male with lupus nephritis V, autoimmune thrombocytopenia, antiphospholipid syndrome (APS), and alveolar hemorrhage, was treated with high-dose steroids, azathioprine, mycophenolate, and rituximab. He developed infections in the lungs, prostate, and possibly colon. N. farcinica was detected in blood cultures. Despite treatment with imipenem, linezolid, TMP/SMX, and moxifloxacin, he died from bronchoaspiration.MethodsA systematic review was conducted using PubMed, Embase, Web of Science, and Scopus. The search terms were (systemic lupus erythematosus OR SLE) AND (rituximab) AND (nocardia), with a timeframe up to 15 March 2024. Inclusion criteria were confirmed cases of Nocardia infection in SLE patients treated with rituximab in the previous year. Non-original studies and secondary research were excluded.ResultsOnly one article was included, describing a 34-year-old male with APS and lupus nephritis IV, treated with high-dose steroids, cyclophosphamide, and rituximab. He had infections in the lungs and brain, with N. farcinica detected in blood cultures. Despite treatment with TMP/SMX and fluoroquinolones, he died from thrombotic complications.ConclusionNocardiosis is more likely in SLE patients due to T lymphocyte immune dysfunction caused by the disease itself, rituximab, and other immunosuppressants. Diagnosis requires a high level of clinical suspicion, supported by long-time blood cultures and 16S rRNA. Beta-lactams and quinolones are reasonable alternatives to TMP/SMX and linezolid, which can worsen the hematological situation, and amikacin, which may worsen lupus nephritis.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"316-325"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insertion/deletion polymorphism of the angiotensin-converting enzyme gene in lupus nephritis at Cho Ray hospital, Vietnam.","authors":"Anh N L Nguyen, Anh T Le, Vincent W S Lee, Huong T B Tran","doi":"10.1177/09612033251317346","DOIUrl":"10.1177/09612033251317346","url":null,"abstract":"<p><p><b>Introduction:</b> The pathogenesis for poor kidney outcomes in lupus nephritis (LN) remains uncertain. There is limited evidence on the association between angiotensin-converting enzyme <i>(ACE) I/D</i> polymorphism and LN with kidney failure. <b>Objectives:</b> To determine the distribution of <i>ACE I/D</i> alleles and genotypes and the correlation between ACE I/D polymorphism and kidney outcomes in LN participants. <b>Subjects and Methods:</b> A cross sectional study was conducted at Cho Ray Hospital (12/2021-07/2023). The LN participants were stratified into 3 groups based on the kidney function and kidney replacement therapy (KRT) on admission. The <i>ACE I/D</i> polymorphism was identified by the polymerase chain reaction. <b>Results:</b> Among 208 LN participants, 71 were in group 1 (eGFR > 60), 55 in group 2 (eGFR ≤ 60 without KRT), 82 in group 3 (eGFR ≤ 60 with KRT). The skewed distribution among 3 groups were observed in <i>D</i> allele (20.4%, 35.5%, 37.2% in group 1, 2, 3, respectively, <i>p</i> = .003) and <i>DD</i> genotype (2.8%, 14.6%, 12.2% in group 1, 2, 3, respectively, <i>p</i> = .005). The <i>ID/DD</i> genotypes increased the susceptibility of kidney failure (eGFR ≤ 60 vs eGFR > 60: OR = 8.26 for <i>DD</i> genotype, OR = 2.31 for <i>ID</i> genotype) and KRT (KRT vs no KRT: OR = 2.01 for <i>ID</i> genotype). <b>Conclusions:</b> The <i>D</i> allele and <i>ID/DD</i> genotypes are linked with the susceptibility of kidney failure in LN participants.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"300-306"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steroid-induced diabetes in lupus nephritis patients: Classic risk factors or a different type of diabetes?","authors":"Cristian Alejandro Dimas-Ramírez, Luis André Fortanell-Meza, Diego San Agustín-Morales, Eduardo Brenner-Muslera, Juan Manuel Mejía-Vilet, Paloma Almeda-Valdes, Paola Vázquez-Cárdenas, Javier Merayo-Chalico, Ana Barrera-Vargas","doi":"10.1177/09612033251315976","DOIUrl":"10.1177/09612033251315976","url":null,"abstract":"<p><p>BackgroundGlucocorticoids are frequently employed in systemic lupus erythematosus (SLE) patients and play a critical role in the induction therapy of lupus nephritis (LN), despite their many side effects, including steroid-induced diabetes (SID). Information regarding SID in SLE patients is quite scant.PurposeThe aim of this study was to determine risk factors associated with the development of SID in patients with LN.Research Design A nested case-control study was conducted.Study sampleWe included patients with biopsy-proven LN, who received induction treatment with steroids.Data Collection and/or AnalysisOut of the total of 358 patients, 35 (9.7%) developed SID.ResultsPatients with SID had more metabolic risk factors, including the metabolic score for insulin resistance (METS-IR); more factors related with lupus activity, with higher SLEDAI and SLICC-DI scores; and lower cumulative pre-induction steroid dose. A higher percentage of patients who developed SID received steroid pulses and a lower percentage received antimalarials. After logistic regression, the variables significantly associated with the development of SID were the SLEDAI index (OR 1.25 [95% CI 1.04-1.50], <i>p</i> 0.01), SLICC-DI (OR 4.93 [95% CI 2.14-11.3], <i>p</i> < 0.001), METS-IR (OR 1.17 [95% CI 1.04-1.32], <i>p</i> 0.009), delta METS-IR at 6 months (OR 1.20 [95% CI 1.03-1.39], <i>p</i> 0.01), and the use of antimalarials (OR 0.14, [95% CI 0.02-0.85], <i>p</i> 0.03). After propensity score matching, METS-IR remained a significant predictor of SID. Patients with METS-IR >36.8 were at higher risk (OR: 2.83, 95% CI: 1.09-7.36, <i>p</i> = 0.034).ConclusionsIn conclusion, SDI development in patients receiving induction therapy for LN is associated with both classic metabolic risk factors and SLE-specific factors, and antimalarial use could be associated with a protective effect. Rheumatologists should be aware of this potential complication, in order to implement appropriate management strategies.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"234-242"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoantibody clusters in childhood-onset systemic lupus erythematosus: Insights from a multicenter study with 912 patients.","authors":"Vitor C Trindade, Eloisa Bonfá, Ana P Sakamoto, Maria T Terreri, Nádia E Aikawa, Fernanda J Fiorot, Ana C Pitta, Verena A Balbi, Carlos N Rabelo, Marco F Silva, Aline G Islabão, Glaucia V Novak, Katia T Kozu, Izabel M Buscatti, Lucia M Campos, Adriana Me Sallum, Ana P Assad, Claudia S Magalhães, Roberto Marini, Adriana R Fonseca, Flavio R Sztajnbok, Maria C Santos, Blanca E Bica, Evaldo G Sena, Ana J Moraes, Teresa C Robazzi, Paulo F Spelling, Iloite M Scheibel, Andre S Cavalcanti, Erica N Matos, Luciano J Guimarães, Flavia P Santos, Luciana M Carvalho, Magda Carneiro-Sampaio, Alexandre A Ferraro, Clovis A Silva","doi":"10.1177/09612033251317357","DOIUrl":"10.1177/09612033251317357","url":null,"abstract":"<p><p><b>Objective:</b> To identify clusters of autoantibodies in a large cSLE population and to verify possible associations between different autoantibody clusters and the following variables: demographic data, cumulative clinical and laboratory manifestations, disease activity, cumulative damage and mortality. <b>Methods:</b> A cross-sectional study was performed in 27 Pediatric Rheumatology University centers, including 912 cSLE patients. The frequencies of seven selected autoantibodies (anti-dsDNA, anti-Ro/SSA, anti-La/SSB, anti-Sm, anti-RNP, aCL IgM and/or IgG and LA) were used for cluster analysis using the K-means method. <b>Results:</b> Four distinctive antibody clusters were identified. Cluster 1 (<i>n</i> = 322; 35.31%) was characterized by anti-dsDNA (61.18%), low frequency of antiphospholipid antibodies (<10%), and lower frequency of cutaneous, articular manifestation (<i>p</i> < 0.05) and hypocomplementemia (<i>p</i> < 0.001) compared to the other groups. Cluster 2 (<i>n</i> = 158; 17.32%) comprised anti-dsDNA (93.04%), aCL (87.34%) and LA (39.87%) and higher frequencies of thrombocytopenia (<i>p</i> = 0.006) and antiphospholipid syndrome (<i>p</i> < 0.001) than the other clusters. Cluster 3 (<i>n</i> = 177; 19.41%) was characterized by anti-dsDNA (81.36%), anti-Sm (100%) and anti-RNP (44.63%) antibodies, as well as a higher frequency of proteinuria compared to cluster 4 (58.15% vs 56.13% vs 64.00% vs 49.80%, <i>p</i> = 0.031). Cluster 4 (<i>n</i> = 255; 27.96%) consisted of all 7 autoantibodies, with predominance of anti-dsDNA (72.55%), anti-Ro/SSA (89.8%) and anti-La/SSB (45.88%), with no specific clinical pattern, except by higher pulmonary damage (<i>p</i> = 0.017). <b>Conclusions:</b>Our study suggests that, within the context of cSLE, the coexistence of anti-dsDNA with antiphospholipid autoantibodies is linked to an elevated incidence of antiphospholipid syndrome. This association does not coincide with a proportionate increase in the occurrence of nephritis. Conversely, the cluster of anti-dsDNA with anti-Ro/SSA and anti-La/SSB antibodies was associated with pulmonary damage, requiring close surveillance.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"292-299"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}