A serology‐based approach combined with clinical examination of 125 Ro/SSA‐positive patients to define incidence and prevalence of subacute cutaneous lupus erythematosus

Popovic, Karin; Nyberg, Fredrik; Wahren‐Herlenius, Marie; Nyberg, Filippa

doi:10.1002/art.22286

Cited by 53 publications

(39 citation statements)

References 27 publications

(33 reference statements)

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“…In our patient group an unexpected high frequency of PLE in patients with SS was described. 14 Photosensitivity has not been reported in SS 33 and a larger study of non-selected pSS patients could verify if PLE is indeed more common in these patients as has already been shown by us and others in CLE. 34,35 On the other hand, PLE is frequent in otherwise healthy individuals with negative serological findings, and is found in up to 20% of the population at our latitude.…”

Section: Discussionmentioning

confidence: 67%

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Fine specificity of the Ro/SSA autoantibody response in relation to serological and clinical findings in 96 patients with self-reported cutaneous symptoms induced by the sun

Popovic

Brauner²,

Ek³

et al. 2007

Lupus

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Anti-Ro/SSA assays assist the clinician in distinguishing autoimmune diseases such as Sjögrenś syndrome (SS), systemic lupus erythematosus (SLE) and subacute cutaneous lupus erythematosus (SCLE). The objective of the study was to investigate the fine specificity of the autoantibodies in relation to clinical presentation as well as environmental and endogenous factors such as photosensitivity, smoking and immunoglobulin (Ig) levels in patients with Ro/SSA autoantibodies. Serum samples from 96 anti-Ro/SSA positive photosensitive patients were tested for autoantibody levels by enzyme-linked immunosorbent assay (ELISA) using purified recombinant Ro52 kd, Ro60 kd and La proteins as antigens. The highest levels of anti-Ro52 and anti-La were observed in patients with primary SS, and the lowest levels of anti-Ro52 in chronic cutaneous lupus erythematosus (CCLE). SCLE patients with systemic disease (SLE and/or SS) showed higher levels of anti-Ro52 than SCLE limited to the skin. A correlation between high serum levels of IgG and anti-Ro52 (P < 0.01) and between IgA and anti-Ro52 (P < 0.05) and anti-Ro60 (P < 0.05) was found. Polymorphic light eruption (PLE) was common in all diagnostic groups but did not correlate with autoantibody levels. Smoking was more common in lupus patients than in SS patients. Our findings thus propose different mechanisms for different clinical presentations of Ro/SSA positive patients. The testing of anti-Ro52 antibodies might serve as a prognostic tool in photosensitive cutaneous diseases.

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Section: Discussionmentioning

confidence: 67%

“…14 In short, data on Ro/SSA positive patients during 1996-2002 (n ϭ 1323) in Stockholm county were collected from the three clinical immunological laboratories that perform Ro/SSA analysis in Stockholm. A questionnaire was sent to the patients.…”

Section: Patientsmentioning

confidence: 99%

Fine specificity of the Ro/SSA autoantibody response in relation to serological and clinical findings in 96 patients with self-reported cutaneous symptoms induced by the sun

Popovic

Brauner²,

Ek³

et al. 2007

Lupus

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“…In another Swedish study, the incidence of CLE and SLE was reported to be similar but a direct comparison was not performed [5, 40]. Using a registry of Ro/SSA positive individuals, the incidence of SCLE was 0.7 per 100,000 in Stockholm from 1996-2002 and prevalence of 6.2-14 per 100000 [41]. Interestingly in this study 29% of patients were smokers compared to 18% of adult population supporting current belief that smoking plays a role in CLE pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Systemic Lupus Erythematosus and Cutaneous Lupus Erythematosus in a Predominantly White Population in the United States

Jarukitsopa

Hoganson

Crowson

et al. 2015

Arthritis Care & Research

131

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Objective Epidemiologic studies comparing the incidence and prevalence of systemic lupus erythematosus (SLE) and isolated cutaneous lupus erythematosus (CLE) are few. Olmsted County, Minnesota provides a unique setting for such a study owing to resources of the Rochester Epidemiology Project. We sought to describe and compare the incidence and prevalence of SLE and CLE from 1993 to 2005. Methods SLE cases were identified from review of medical records and fulfilled the 1982 ACR classification criteria. CLE cases included patients with classic discoid LE (CDLE), subacute cutaneous LE (SCLE), lupus panniculitis and bullous LE. Age-and sex-adjusted incidence and prevalence were standardized to 2000 US white population. Results The age- and sex-adjusted incidence of SLE (2.9 per 100,000; 95% CI 2.0, 3.7) was similar to that of CLE (4.2 per 100,000; 95% CI 3.1, 5.2, p= 0.10). However, incidence of CLE was three times higher than SLE in males (2.4 versus 0.8 per 100,000, p=0.009). The age- and sex-adjusted prevalence of CLE on January 1, 2006 was higher than that of SLE (70.4 versus 30.5 per 100,000; p<0.001). The prevalence of CLE and SLE in women were similar but the CLE prevalence was higher in men than in women (56.9 versus 1.6 per 100,000, p<0.001). The incidence of CLE rose steadily with age and peaked at 60-69 years. Conclusion The incidences of CLE and SLE are similar but CLE is more common than SLE in males and in older adults. These findings may reflect differences in genetic or environmental etiology of CLE.

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“…As part of their autoimmune disease, pSS patients have a changed pattern in B-cell maturation and proliferation, resulting in hypergammaglobulinemia and autoantibodies against the antigens Ro/SSA (Ro52 and Ro60) and La/SSB [1–5]. Recently, autoantibodies against the Ro52 antigen were shown to functionally inhibit ubiquitination mediated by the E3 ligase and to correlate with disease activity [6–8]. …”

Section: Introductionmentioning

confidence: 99%

Difference in clinical presentation between women and men in incident primary Sjögren’s syndrome

et al. 2017

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BackgroundA more severe disease phenotype has been reported in men compared to women in several rheumatic diseases. However, studies have not conclusively established sex-related clinical features in primary Sjögren’s syndrome (pSS). In this study, we therefore investigated the clinical presentation of pSS in women and men at diagnosis.MethodsIncident, treatment naïve patients (n = 199) during a 5-year period in a specified area were prospectively included and examined for items of classification criteria for pSS as well as extraglandular manifestations (EGM). Serum was sampled at the time of diagnosis and anti-Ro52/SSA levels were measured by ELISA. Replication of significant findings was confirmed in an independent cohort of pSS patients (n = 377), and meta-analysis was performed.ResultsAn increased frequency of extraglandular manifestations in men was observed and replicated (p = 0.05, p = 0.0003, and p meta = 0.002). This related to pulmonary involvement, vasculitis, and lymphadenopathy being more common in men, for whom a lower age at diagnosis was observed in the exploratory cohort. Additionally, SSA-positive male patients had significantly higher levels of anti-Ro52 levels than their female counterparts in sera available for analysis (p = 0.02).ConclusionsOur analysis of two independent cohorts of incident pSS demonstrates that the presence and number of EGM are significantly more frequent among men with pSS than women at diagnosis. Importantly, around half of the male patients presented with more than one EGM at diagnosis, supporting the conclusion that pSS in men represents a more severe form of disease, regardless of the lower risk for men to develop pSS.

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A serology‐based approach combined with clinical examination of 125 Ro/SSA‐positive patients to define incidence and prevalence of subacute cutaneous lupus erythematosus

Cited by 53 publications

References 27 publications

Fine specificity of the Ro/SSA autoantibody response in relation to serological and clinical findings in 96 patients with self-reported cutaneous symptoms induced by the sun

Fine specificity of the Ro/SSA autoantibody response in relation to serological and clinical findings in 96 patients with self-reported cutaneous symptoms induced by the sun

Epidemiology of Systemic Lupus Erythematosus and Cutaneous Lupus Erythematosus in a Predominantly White Population in the United States

Difference in clinical presentation between women and men in incident primary Sjögren’s syndrome

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