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FRI0220 Stable anti-ro and anti-la serological profile in anti-ro and anti-la negative sialadenitis and sjÖgren’s syndrome patients as disease progresses
  1. MM Zandbelt,
  2. LB Van de Putte,
  3. FH Van den Hoogen
  1. Rheumatology, University Medical Center, Nijmegen, Netherlands

Abstract

Background It is generally considered that more weight should be put on objective signs in the classification criteria for Sjögren’s syndrome SS). Such objective findings include the presence of anti-Ro- and anti-La-antibodies, as well as the sublabial gland histology expressed in focus-score (FS) and IgA containing plasmacells percentage (IgA%) score. So far, anti-Ro and/or anti-La autoantibodies in the patient?s serum have been the most sensitive (40–80%) and specific serological markers for Sjögren’s syndrome.

Objectives The aim of this study is to investigate whether sero-conversion from anti-Ro- and anti-La antibodies negative to positive occurs in our SS and focal sialadenitis patients after disease has progressed for a minimum of five years since diagnosis.

Methods Blood samples were taken from 20 patients, and sera were measured for presence of anti-Ro- or anti-La antibodies using ELISA and counter immune electrophoresis (CIE). Twelve patients fulfilled the ESG criteria for Sjögren’s syndrome. Five of them were diagnosed with primary SS and 7 were diagnosed with secondary SS. Histologic (FS > 1, IgA% < 70) underlined the diagnosis. The remainder 8 patients with sicca symptoms and FS > 1 did not meet the ESG criteria and were therefore diagnosed as having focal sialadenitis.

Results In the ELISA no anti-Ro or anti-La positive sera were detected. An initial CIE, performed as confirmation measurement technique, showed three possibly positive sera. However, in a second CIE these sera were identified as anti-RNP antibodies positive sera.

Conclusion These results confirm other observations that the serological profile in patients with Sjögren’s syndrome is stable as disease progresses. There appears to be no need for repeated measurements of anti-Ro- or anti-La antibodies presence in anti-Ro- and anti-La negative patients? sera. Further investigations should point out whether measurement for presence of these autoantibodies in exocrine tissue itself or in exocrine glands products such as saliva is preferable over serological analysis in terms of disease-sensitivity. These alternative methods might be necessary to increase accuracy of the diagnosis since at least 20% of SS patients show a sustained lack of anti-Ro and anti-La antibodies in their serum.

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