Criteria for the classification of systemic lupus erythematosus—status 1972

320

150

Clinical, serologic, and genetic findings in Sjögren's syndrome patients were correlated with quantitative determinations for antibody against Ro (SS‐A), La (SS‐B), and nRNP (Sm) using newly developed, sensitive solid‐phase assays. In 86 Sjögren's syndrome patient sera, more than 96% had anti‐Ro (SS‐A), and 87% had anti‐La (SS‐B), spanning a 4.8 log10 range of autoantibody concentration, whereas only 95% of the patients had anti‐nRNP (Sm). Low levels of anti‐Ro (SS‐A) and anti‐La (SS‐B) were found in 10% and 12.5%, respectively, of the 40 normal control sera. In Sjögren's syndrome patients, the level of anti‐Ro (SS‐A) correlated strongly with that of anti‐La (SS‐B) (r = 0.80; P 0.0001) but not with the level of anti‐nRNP (Sm). We found much higher levels of anti‐Ro (SS‐A) and anti‐La (SS‐B) in patients with purpura, leukopenia, lymphopenia, and increased polyclonal gamma globulins than in those without these conditions (between 4.3‐fold and 17‐fold higher; P < 0.001 to P < 0.05). Anti‐Ro (SS‐A) and anti‐La (SS‐B) levels correlated with the rheumatoid factor titer and with the concentrations of total globulin, IgG, and IgA, but not with the IgM concentration. The association of rheumatoid factor titer with levels of anti‐Ro (SS‐A) and anti‐La (SS‐B) occurred only in patients with primary Sjögren's syndrome. Antinuclear antibody titers correlated with levels of anti‐Ro (SS‐A) and anti‐nRNP (Sm). HLA‐DR3‐positive patients had higher levels of anti‐Ro (SS‐A) and anti‐La (SS‐B).

Section: Methodsmentioning

confidence: 99%

Anti‐Ro (SS‐A) and Anti‐La (SS‐B) in patients with Sjögren's syndrome

Harley

Alexander

Bias

et al. 1986

320

150

“…This group included 21 patients comprising 19 women and 2 men, ages 20-82 (mean age 43), who fulfilled the American Rheumatism Association preliminary diagnostic criteria for SLE (18). (The 1982 revised criteria for the classification of SLE had not been developed when this prospective study began in 1979.…”

Section: Methodsmentioning

confidence: 99%

Nailfold capillary microscopy in mixed connective tissue disease. Comparison with systemic sclerosis and systemic lupus erythematosus

Granier

Vayssairat

Priollet

et al. 1986

Nailfold capillary microscopy patterns in 22 patients with mixed connective tissue disease (MCTD) were compared with those of 21 patients with systemic lupus erythematosus (SLE) and 30 patients with systemic sclerosis (scleroderma [SD]). Microvascular data were classified blindly as follows: normal, nonspecific abnormalities, SD pattern, and SLE pattern, with special attention to the presence of dystrophic, branched "bushy" capillary formations. Of the 22 patients with MCTD, 63.6% had an SD pattern, 22.7% had an SLE pattern, 13.6% had nonspecific abnormalities, and 72.7% had bushy capillary formations. Compared with SLE microangiopathy, MCTD microangiopathy exhibited significantly greater capillary loss (P < 0.05), more frequent SD patterns (P < 0.001), and more frequent bushy capillaries (P < 0.001). Compared with SD patients, MCTD patients displayed less frequent SD patterns (P < 0.02) and more frequent bushy capillary formations (P < 0.01). The presence of bushy capillaries was suggestive of MCTD. For diagnostic purposes, bushy capillaries displayed 72% sensitivity, 80% specificity, and 87.2% negative predictive value. The quantitative and qualitative expressions of microangiopathy were different in MCTD and SLE, respectively. This supports the hypothesis that each disease is a distinct entity. Nevertheless, there were many resemblances

“…Diagnostic criteria. Patients were classified as having SLE or rheumatoid arthritis by criteria developed by the American Rheumatism Association (30,3 …”

mentioning

confidence: 99%

Enzyme immunoassay for antibodies to native DNA

Eaton

Schnneider

Schur

1983

109

An enzyme immunoassay was developed to detect antibodies to native DNA; DNA coating conditions that maximized sensitivity, specificity, and reproducibility were selected. Sera of patients with systemic lupus erythematosus (SLE) were positive more frequently by this immunoassay than by the Crithidiu luciliae assay or by counterimmunoelectrophoresis. By enzyme immunoassay, 94% of sera with active SLE and 70% of sera from patients with inactive SLE were positive, as were 16% from those suspected of having SLE, and 2.5% of normal persons. Specificity for native DNA was shown for both SLE and normal sera by inhibition studies and by S1 nuclease treatment of polystyrene-bound native DNA. The enzyme immunoassay correlated more with serum hemolytic complement levels than did the other 2 assays, suggesting that it detects biologically more relevant anti-DNA antibodies than do the other 2 tests.Measurement of serum anti-DNA antibody levels has been helpful in both the diagnosis and clinical assessment of systemic lupus erythematosus (SLE) detect antibodies to native DNA (nDNA), including immunodiffusion (7), complement fixation (8,9), agglutination (lO,ll), immunofluorescence (6,12), and radioimmunoassays (13-18). The sensitivity, specificity, cost, and ease of performance of these assays vary considerably (19,20).(The enzyme immunoassay (EIA) appears to offer advantages over other assays in areas of sensitivity, reproducibility, and efficiency, without sacrificing specificity. Since the initial description by Engvall and Perlmann (21), many antigens have been bound to solid phases to detect antibodies by EIA. Most of these antigens have been proteins or polysaccharides, but the binding of nucleic acids to polystyrene has not been systematically studied. Recently, several papers have appeared describing the application of EIAs to detect antibodies to DNA (22-29). In each of these reports different conditions were used, and the success of binding nDNA to the solid phase has varied (23,25).The purpose of the present study was to develop an EIA that could detect antibodies to nDNA, including a reproducible and reliable method for binding of DNA to the solid phase; this EIA was to be both sensitive and specific. In addition, the antibodies detected by the EIA were compared with those detected by other tests to define the (biologic) quality and relevance of the antibodies analyzed by different techniques. MATERIALS AND METHODSSource of sera. Normal human sera were obtained either from hospital personnel (sera kindly provided by Mr.