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Antinucleosome Antibodies in Patients with Juvenile Systemic Lupus Erythematosus

Department of Pediatrics, University of São Paulo, São Paulo, Brazil, barcelos.ops{at}terra.com.br

MHB Kiss

Department of Pediatrics, University of São Paulo, São Paulo, Brazil

MA Scheinberg

Hospital Israelita Albert Einstein and Research Institute, São Paulo, Brazil

CLP Mangueira

Hospital Israelita Albert Einstein and Research Institute, São Paulo, Brazil

CA Silva

Department of Pediatrics, University of São Paulo, São Paulo, Brazil

Our objective was to evaluate the frequency of antinucleosome antibodies (anti-Ncs) in juvenile systemic lupus erythematosus (JSLE) comparing it to that observed for anti-DNA and to correlate the presence of these antibodies with clinical manifestations and disease activity. Anti-Ncs and anti-DNA were detected by ELISA in 74 patients with JSLE and 64 normal controls. Clinical records were reviewed. Disease activity was assessed by SLEDAI score. Anti-Ncs and anti-DNA showed sensitivity of 52.7% and 54% and specificity of 98.4% and 95.3%, respectively. Disagreement between the two assays was found in 25.7% of the cases: isolated positive Anti-Ncs in nine cases (12.2%) and isolated positive anti-DNA in 10 cases (13.5%). Agreement was found in 74.3%: both positive antibodies in 30 cases and both negative in 25. The presence of anti-Ncs was significantly associated with malar erythema, hemolytic anemia, anti-DNA and low complement levels, but not with renal manifestations. The presence of anti-Ncs was associated with a higher SLEDAI median (P < 0.001) and its titers correlated with the SLEDAI score (r = 0.504; P < 0.001). The frequency, sensitivity and specificity values were similar between anti-Ncs and anti-DNA antibodies in patients with JSLE. Nevertheless, the discordance of 25.7% between the two assays suggests that both antibodies may have a complementary diagnostic role. The association and correlation between anti-Ncs and several disease activity parameters demonstrated its usufulness in the follow-up of these patients.

Key Words: antinucleosome antibodies • auto-antibodies • children • disease activity • systemic lupus erythematosus

Lupus, Vol. 15, No. 8, 496-500 (2006)
DOI: 10.1191/0961203306lu2317oa


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