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AB0555 Systemic Lupus Erythematosus with or Without Anti-Dsdna Antibodies: not so Different
  1. C. Perricone1,
  2. F. Ceccarelli1,
  3. L. Massaro2,
  4. C. Alessandri1,
  5. F.R. Spinelli1,
  6. E. Marocchi1,
  7. F. Miranda1,
  8. S. Truglia1,
  9. G. Valesini1,
  10. F. Conti2
  1. 1Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche
  2. 2Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy

Abstract

Background Systemic Lupus Erythematosus (SLE) is an autoimmune disease, characterized by the production of a wide range of autoantibodies, resulting from polyclonal B cells activation, impaired apoptotic pathways, or idiotypic network dysregulation. The anti-double stranded DNA antibodies (anti-dsDNA) are considered a specific marker for SLE, due to their high frequency, sensitivity and specificity (57.3% and 97.4%, respectively). Moreover, their identification in other pathological conditions and in healthy subjects is very rare (less than 0.5%). These antibodies have been associated with kidney involvement and disease activity, however, a comparison between large cohorts of SLE patients with or without anti-dsDNA is lacking.

Objectives We aimed at evaluating the demographic, clinical, and laboratory features of SLE patients according with the anti-dsDNA status.

Methods According with the anti-dsDNA status, we identified three groups of patients: Group 1 (persistently positive); Group 2 (positive at diagnosis who became negative); Group 3 (persistently negative). Disease activity was assessed using the European Consensus Lupus Activity Measurement (ECLAM).

Results We evaluated 393 SLE patients (Group 1: 62.3%; Group 2: 13.3%; Group 3: 24.4%). The renal involvement was significantly more frequent in those patients who were persistently positive for anti-dsDNA (P=0.001). Conversely, serositis resulted significant more frequent in those persistently negative (P<0.0001). The anti-RNP and the reduction of C4 serum levels were found significantly more frequently in Group 1 and 2 (P=0.04, P=0.005). The anti-dsDNA status did not influence disease activity (ECLAM group 1 vs group 2 vs group 3 =NS). Finally, the therapeutic approach was not different between the groups except for the use of cyclosporine A which was more frequently prescribed in the persistently positive patients (60 patients, 24.5%) compared to Group 2 and 3 [9 (17.3%) and 12 (12.5%) patients, respectively; P=0.01].

Conclusions The main clinical feature associated with anti-dsDNA positivity is the kidney involvement. Nonetheless, disease activity evaluated with ECLAM, thus with an index which does not include anti-dsDNA evaluation, does not seem to be influenced by the presence of anti-dsDNA.

Disclosure of Interest None declared

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