Concise reports
Anti-Ro/SS-A and anti-La/SS-B antibodies associated with cardiac
involvement in childhood systemic lupus erythematosus
Divisions of Rheumatology and
Cardiology, Department of Pediatrics, Louisiana State University
Medical Center and Children's Hospital, New Orleans, Louisiana, USA
Correspondence to: Dr A Gedalia, Department of Pediatrics, LSUMC, 1542 Tulane Avenue, New Orleans, LA 70112-2822, USA.
Accepted for publication 5 February 1997
OBJECTIVES
To determine the frequency and type
of cardiac manifestations in children with systemic lupus erythematosus
(SLE) and investigate whether cardiac involvement of SLE in children
was associated with any autoantibody pattern.
METHODSRetrospective analysis of the medical
records of all children with SLE (31 patients) seen between January
1984 and January 1994 by the paediatric rheumatology service at
Children's Hospital in New Orleans. All patients satisfied the
American College of Rheumatology criteria for the diagnosis of SLE.
Paediatric SLE patients with cardiac manifestations based on
echocardiogram were identified. Autoantibody tests at diagnosis were
identified retrospectively by chart review, and the correlation between
autoantibodies and cardiac involvement was analysed using the two
tailed Fisher's exact test.
RESULTSThirteen (42%) of 31 SLE patients had
cardiac manifestations of SLE. Seven (22%) had pericarditis without
myocarditis, five (16%) had pericarditis and myocarditis, and one
(3%) had myocarditis without pericarditis. Two patients (6%) with
pericarditis had cardiac tamponade. Cardiac manifestations of SLE
usually occurred at the time of diagnosis or within six months.
Anti-Ro/SS-A antibodies were present in serum samples of nine of 11 (82%) patients with cardiac involvement and in five of 15 (33%)
without cardiac involvement (p=0.02). Anti-La/SS-B antibodies were
present in serum samples of six of 10 (60%) patients with cardiac
involvement and two of 15 (13%) without cardiac involvement (p=0.03).
Anti-Sm and anti-RNP antibodies showed no correlation with the presence
of cardiac disease.
CONCLUSIONSCardiac involvement in our
paediatric SLE population was frequently found and correlated
significantly with the presence of anti-Ro/SS-A and anti-La/SS-B antibodies.
© 1997 by Annals of the Rheumatic Diseases
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