RT Journal Article
SR Electronic
T1 Autoantibodies in Pediatric Systemic Lupus Erythematosus: Ethnic Grouping, Cluster Analysis, and Clinical Correlations
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 416
OP 421
DO 10.3899/jrheum.080588
VO 36
IS 2
A1 ROMAN JURENCÁK
A1 MARVIN FRITZLER
A1 PASCAL TYRRELL
A1 LINDA HIRAKI
A1 SUSANNE BENSELER
A1 EARL SILVERMAN
YR 2009
UL http://www.jrheum.org/content/36/2/416.abstract
AB Objective. (1) To evaluate the spectrum of serum autoantibodies in pediatric-onset systemic lupus erythematosus (pSLE) with a focus on ethnic differences; (2) using cluster analysis, to identify patients with similar autoantibody patterns and to determine their clinical associations. Methods. A single-center cohort study of all patients with newly diagnosed pSLE seen over an 8-year period was performed. Ethnicity, clinical, and serological data were prospectively collected from 156/169 patients (92%). The frequencies of 10 selected autoantibodies among ethnic groups were compared. Cluster analysis identified groups of patients with similar autoantibody profiles. Associations of these groups with clinical and laboratory features of pSLE were examined. Results. Among our 5 ethnic groups, there were differences only in the prevalence of anti-U1RNP and anti-Sm antibodies, which occurred more frequently in non-Caucasian patients (p < 0.0001, p < 0.01, respectively). Cluster analysis revealed 3 autoantibody clusters. Cluster 1 consisted of anti-dsDNA antibodies. Cluster 2 consisted of anti-dsDNA, antichromatin, antiribosomal P, anti-U1RNP, anti-Sm, anti-Ro and anti-La autoantibody. Cluster 3 consisted of anti-dsDNA, anti-RNP, and anti-Sm autoantibody. The highest proportion of Caucasians was in cluster 1 (p < 0.05), which was characterized by a mild disease with infrequent major organ involvement compared to cluster 2, which had the highest frequency of nephritis, renal failure, serositis, and hemolytic anemia, or cluster 3, which was characterized by frequent neuropsychiatric disease and nephritis. Conclusion. We observed ethnic differences in autoantibody profiles in pSLE. Autoantibodies tended to cluster together and these clusters were associated with different clinical courses.