BackgroundAntihistone antibodies (AHA) have been linked to Drug-Induced Lupus Erythematosus (DILE) for decades1. However, for some authors this relationship is not so clear and sugest that the presence of these autoantibodies is related to other autoimmune diseases more frequently2,3,4.ObjectivesThe main objetive of this work was to study the association of AHA with different autoimmune entities (including DILE) and secondarily, look into which clinical manifestations and which autoantibodies are more frequently related to AHA.MethodsWe performed a descriptive study. A database was constituted using all patients with AHA+ in any blood analysis between years 2000 and 2016 in the University Hospital Complex of Vigo. The variables of the study were: presence of autoimmune disease, clinical manifestations and related autoantibodies.ResultsVariableMenWomenAll% Total Age504546Gender155873100SLE8273548DILE0000Scleroderma0445Sjögren18912Rheumatoid Arthritis0334No diagnosis5192433Malar rash1111216Photosensitivity2111318Oral ulcers1101115Arthritis6313751Lupic nephropathy4131723Raynaud1111216Hematological abnormalities5202534AntiRo+4121622AntiLa+25710AntiSm+381115AntiDNAds+3252838None of the 73 patients AHA+ developed DILE while almost the 50% of them suffer any other autoimmune disease. We found a high percentage of AHA+ patients with lupus erythematous complications such as arthritis and hematological abnormalities. AntiDNAds antibody was the more frequent coexpressed autoantibody.Conclusions AHA detection is not useful as DILE screening.AHA+ sugest the presence of other autoimmune disease rather than DILE.AHA+ may be related to lupus erythematous systemic complications. References Fritzler MJ, Tan EM. Antibodies to histone in drug-induced and idiopathic lupus erythematosus. J Clin Invest. 1978;62:560–567.Peng SL, Craft J. Antinuclear antibodies. In: Ruddy S, Harris ED, Sledge CB, eds. Kelley's Textbook of Rheumatology. 6th ed. Philadelphia, Pa: WB Saunders; 2001:166.Kubo M, Ihn H, Yasawa N, et al. Prevalence and antigen specificity of antihistone antibodies in patients with polymyositis/dermatomyositis. J Invest Dermatol. 1999;112:711–715.Zirwas MJ, Kress DW, Deng JS. The Utility of Antihistone Antibody Screening in the Diagnosis of Drug-Induced Lupus Erythematosus. Arch Dermatol Apr 2004; VOL 140: 494–495. Disclosure of InterestNone declared
BackgroundExposure to silica dust has been associated with different autoimmune diseases and immunological abnormalities in which microvascular involvement is very common, as systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis or dermatomyositis.ObjectivesTo show capillaroscopic findings in patients exposed and not exposed to silica and to analyze the differences between both groups.MethodsA case control design was made. Cases (Si+) were subjects exposed to silica (with and without silicosis). Controls (Si-) were healthy subjects not exposed to silica. Capillaroscopy was made with both Zuzi® Optical stereo microscope with Optikam® camera adapted and with USB Digital Microscope Video epiluminiscence Dino-Lite ® in each patient. The capillaroscopic alterations were evaluated according to a semiquantitative method. Background data on CVRF and variables related to capillaroscopy were collected. A comparative study was done.ResultsCapillaroscopy was performed on 61 Si+ and 12 Si- subjects. Mean age of Si+ was 52.6 years (SD: 7.3) and 54 years (SD: 6.6) in Si-. There were no significant differences in CVRF: hypertension (13.1% Si+ and 8.3% Si-), diabetes mellitus (3.3% Si+ and 8.3% Si-) and tobacco exposure (18.0% Si+ and 25.0% Si-). It was observed capillary dilation in 24 (33.9%) Si+ and only in 3 (25.0%) Si-. The dilation score was mild in all Si- while in Si+ was mild in 41.7%, moderate in 37.5% and extreme in 12.5%. 42.7% of Si + had a degree of tortuosity higher than 33% (score 2) whereas in all Si- the degree of tortuosity was <33% (score 1). Capillaroscopic general pattern showed differences between both groups: it was normal in 24 (42.1%) Si+ and 9 (75%) Si-; slightly irregular in 30 (52.6%) Si+ and 3 (25%) Si- and unstructured in 3 Si+ (5.3%) and in none Si-.ConclusionsThe current study shows significant differences between the capillaroscopy of subjects exposed and not exposed to silica, with a trend in more frequency and severity of capillary dilatation, greater frequency of tortuosity in a severe degree and more frequent irregular capillaroscopic pattern in the exposed patients.References Blanc PD, Järvholm B, Torén K. Prospective risk of rheumatologic disease associated with occupational exposure in a cohort of male construction workers. Am J Med 2015;128(10):1094–101. Disclosure of InterestNone declared
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