Autoantibody clusters in childhood-onset systemic lupus erythematosus: Insights from a multicenter study with 912 patients

被引：0

作者：

Trindade, Vitor C. ^{[1
,2
]}

Bonfa, Eloisa ^{[2
,3
]}

Sakamoto, Ana P. ^{[4
]}

Terreri, Maria T. ^{[4
]}

Aikawa, Nadia E. ^{[1
,2
,3
]}

Fiorot, Fernanda J. ^{[1
]}

Pitta, Ana C. ^{[1
]}

Balbi, Verena A. ^{[1
]}

Rabelo Jr, Carlos N. ^{[5
]}

Silva, Marco F. ^{[5
]}

Islabao, Aline G. ^{[6
]}

Novak, Glaucia, V ^{[1
]}

Kozu, Katia T. ^{[1
]}

Buscatti, Izabel M. ^{[1
]}

Campos, Lucia M. ^{[1
]}

Sallum, Adriana M. E. ^{[1
]}

Assad, Ana P. ^{[2
,3
]}

Magalhaes, Claudia S. ^{[7
]}

Marini, Roberto ^{[8
]}

Fonseca, Adriana R. ^{[9
]}

Sztajnbok, Flavio R. ^{[10
]}

Santos, Maria C. ^{[11
]}

Bica, Blanca E. ^{[12
]}

Sena, Evaldo G. ^{[13
]}

Moraes, Ana J. ^{[14
]}

Robazzi, Teresa C. ^{[15
]}

Spelling, Paulo F. ^{[16
]}

Scheibel, Iloite M. ^{[17
]}

Cavalcanti, Andre S. ^{[18
]}

Matos, Erica N. ^{[19
]}

Guimaraes, Luciano J. ^{[20
]}

Santos, Flavia P. ^{[21
]}

Carvalho, Luciana M. ^{[22
]}

Carneiro-Sampaio, Magda ^{[1
,2
]}

Ferraro, Alexandre A. ^{[1
,2
]}

Silva, Clovis A. ^{[1
,2
]}

机构：

[1] Hosp Clin HCFMUSP, Pediat Rheumatol Unit, Inst Crianca & Adolescente, Sao Paulo, Brazil

[2] Univ Sao Paulo, Fac Med, Sao Paulo, Brazil

[3] Hosp Clin HCFMUSP, Div Rheumatol, Sao Paulo, Brazil

[4] Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, Brazil

[5] Hosp Infantil Albert Sabin, Pediat Rheumatol Unit, Fortaleza, Brazil

[6] Hosp Crianca Brasilia Jose Alencar, Pediat Rheumatol Unit, Brasilia, Brazil

[7] Sao Paulo State Univ UNESP, Pediat Rheumatol Unit, Botucatu, Brazil

[8] Univ Campinas Unicamp, Pediat Rheumatol Unit, Campinas, Brazil

[9] Rio Janeiro Fed Univ UFRJ, Pediat Rheumatol Unit, IPPMG, Rio De Janeiro, Brazil

[10] Pedro Ernesto Univ Hosp, Pediat Rheumatol Unit, Rio De Janeiro, Brazil

[11] Irmandade Santa Casa Misericordia Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, Brazil

[12] Univ Fed Rio Janeiro, Rheumatol Div, Rio de Janeiro, Brazil

[13] Lauro Wanderley Univ Hosp, Pediat Rheumatol Unit, Joao Pessoa, Brazil

[14] Fed Univ Para, Pediat Rheumatol Unit, Belem, Brazil

[15] Fed Univ Para, Pediat Rheumatol Unit, Belem, Brazil

[16] Hosp Evangel Curitiba, Pediat Rheumatol Unit, Curitiba, Brazil

[17] Hosp Crianca Conceicao, Pediat Rheumatol Unit, PORTO ALEGRE, Brazil

[18] Univ Fed Pernambuco, Pediat Rheumatol Unit, Recife, Brazil

[19] Univ Fed Mato Grosso do Sul, Pediat Rheumatol Unit, Campo Grande, Brazil

[20] Univ Brasilia, Pediat Rheumatol Unit, Brasilia, Brazil

[21] Univ Fed Minas Gerais, Pediat Rheumatol Unit, Belo Horizonte, Brazil

[22] Univ Sao Paulo, Ribeirao Preto Med Sch, Pediat Rheumatol Unit, Ribeirao Preto, Brazil

来源：

LUPUS | 2025年 / 34卷 / 03期

关键词：

Childhood-onset systemic lupus erythematosus; autoantibody; cluster analysis; antiphospholipid syndrome; pulmonary damage; RHEUMATOLOGY DAMAGE INDEX; ANTIPHOSPHOLIPID SYNDROME; CLASSIFICATION CRITERIA; DISEASE-ACTIVITY; UPDATE; MANIFESTATIONS; VALIDATION; MANAGEMENT; ANTIBODY;

D O I：

暂无

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: 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. Methods: 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. Results: Four distinctive antibody clusters were identified. Cluster 1 (n = 322; 35.31%) was characterized by anti-dsDNA (61.18%), low frequency of antiphospholipid antibodies (<10%), and lower frequency of cutaneous, articular manifestation (p < 0.05) and hypocomplementemia (p < 0.001) compared to the other groups. Cluster 2 (n = 158; 17.32%) comprised anti-dsDNA (93.04%), aCL (87.34%) and LA (39.87%) and higher frequencies of thrombocytopenia (p = 0.006) and antiphospholipid syndrome (p < 0.001) than the other clusters. Cluster 3 (n = 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%, p = 0.031). Cluster 4 (n = 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 (p = 0.017). Conclusions: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.

引用

页码：292 / 299

页数：8

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