Drug-Induced, Ro/SSA-Positive Cutaneous Lupus Erythematosus

Srivastava, Monika; Rencic, Adrienne; Diglio, Gerardine; Santana, Helen; Bonitz, Paula; Watson, Rosemarie; Ha, Esther; Anhalt, Grant J.; Provost, Thomas T.; Nousari, Carlos H.

doi:10.1001/archderm.139.1.45

Cited by 143 publications

(107 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A maior importância clínica do anti-SSA/Ro está relacionada à sua associação com o lúpus neonatal, o bloqueio congênito cardiovascular, em crianças nascidas de mães com esse auto-anticorpo, e lúpus eritematoso cutâneo subagudo (9)(10)(11) . Esse auto-anticorpo é um dos critérios de diagnóstico dos pacientes com síndrome de Sjögren, sendo encontrado em 50-90% dos pacientes, geralmente também associado com outro complexo antigênico, o SSB/La.…”

Section: Introductionunclassified

Padrões de imunofluorescência do fator antinuclear (FAN) em células HEp-2 de soros reagentes para anti-SSA/Ro

Lora¹,

Laurino²,

Freitas³

et al. 2007

Rev. Bras. Reumatol.

View full text Add to dashboard Cite

RESUMOObjetivo: avaliar os padrões de imunofluorescência do fator antinuclear (FAN) em soros reagentes para anticorpos anti-SSA/Ro e sua associação clínica. Método: foi realizado um estudo transversal retrospectivo, no qual foram revisadas as solicitações de anticorpos antiantígenos nucleares extraíveis (anti-ENA) encaminhadas ao SPC/HCPA no período de dois anos. Das solicitações com resultado positivo para anti-ENA identificou-se qual ou quais auto-anticorpos estavam envolvidos (anti-SSA/Ro, anti-SSB/La, anti-RNP, anti-Sm, anti-Scl-70), bem como os padrões de imunofluorescência do FAN e os quadros clínicos dos pacientes anti-SSA/Ro positivo. As técnicas usadas para detecção e identificação foram FAN por imunofluorescência indireta (IFI) em células HEp-2 e anti-ENA por hemaglutinação. Resultados: das 392 solicitações analisadas 90 eram anti-ENA positivo. Houve um predomínio do sexo feminino (94%) (86/91) e a idade média foi de 42 anos. O anti-SSA/Ro foi o mais freqüente (67,8%) (61/90), sendo que todas as amostras anti-SSA/Ro positivas eram positivas para o FAN. O padrão de imunofluorescência nuclear pontilhado fino foi o predominante (68,9%) (42/61) nos pacientes com anti-SSA/Ro positivo, e o quadro clínico mais encontrado foi de lúpus eritematoso sistêmico, em 50,8% (31/61) dos pacientes. Conclusão: o teste de FAN por IFI utilizando células HEp-2 é um bom método de triagem para detecção de auto-anticorpos anti-SSA/Ro, apresentando maior associação com o padrão nuclear pontilhado fino. Diferente do que tem sido descrito na literatura, não encontramos nenhuma amostra de pacientes com anti-SSA/Ro que tenham apresentado FAN falso-negativo na IFI. Pelo menos na nossa experiência, esses dados questionam o custo-efetividade da solicitação de rotina desse exame em pacientes FAN negativo pelo teste de IFI.Palavras-chave: auto-anticorpo, fator antinuclear, anticorpos anti-SSA/Ro, anti-ENA. ABSTRACTObjective: to evaluate the pattern at immunofluorescence of the antinuclear antibodies (ANA) detected by the indirect immunofluorescence (IIF) technique in positive samples for anti-SSA/Ro autoantibody and the clinical associations. Methods: a retrospective transversal study was performed in a period of two years where the all the solicitations of testing for the presence of anti-extractable nuclear antigen (anti-ENA) antibodies delivered to the SPC/HCPA were analyzed. We selected the positive samples and identified which autoantibodies were involved (anti-SSA/RO, anti-SSB/La, anti-RNP, anti-Sm and anti-Scl70) as well as the immunofluorescence patterns by ANA testing and the clinical associations found in the patients presenting anti-SSA/Ro positive serum. IIF was used for ANA using HEp-2 cells and hemagglutination for anti-ENA antibodies detection. Results: 90 out of the 392 solicitations analyzed were anti-ENA positive, with a predominance of women (86/91 -94%) and the mean age was 42 years old. The most frequent autoantibody was anti-SSA/Ro (61/90 -67.8%) and all samples that were anti-SSA/Ro positive were also ANA positive...

show abstract

Section: Introductionunclassified

Padrões de imunofluorescência do fator antinuclear (FAN) em células HEp-2 de soros reagentes para anti-SSA/Ro

Lora¹,

Laurino²,

Freitas³

et al. 2007

Rev. Bras. Reumatol.

View full text Add to dashboard Cite

show abstract

“…The patient in the case had a MMI medication and typical joint symptoms one month later which was accord with the literature description. Pertinent literature told that DIL was generally observed from 2 weeks to 3.2 years after exposure to a specific drug (3,18). We promptly discontinued MMI therapy and administered non-steroidal anti-inflammatory drugs.…”

Section: Discussionmentioning

confidence: 99%

Anti-thyroid drug-induced lupus: a case report and review of the literature

Qiu

et al. 2016

Arch. Endocrinol. Metab.

View full text Add to dashboard Cite

show abstract

“…After drug discontinuation, scle skin lesions improve within weeks and resolve without scarring in most patients 8 . Autoantibody titres generally take longer to decline and often persist 6 .…”

Section: Discussionmentioning

confidence: 99%

Drug-Induced Subacute Cutaneous Lupus Erythematosus Associated with Nab-Paclitaxel Therapy

et al. 2013

View full text Add to dashboard Cite

by fluorescence in situ hybridization. Computed tomography imaging revealed lesions in keeping with small-volume lung and liver metastases and bilateral ovarian metastases.The patient was therefore started on first-line systemic therapy for metastatic breast cancer, using nanoparticle albumin bound (nab)-paclitaxel 260 mg/m 2 intravenously every 21 days. She initially tolerated the nab-paclitaxel well, with toxicities limited to alopecia and mild fatigue. After the third infusion, she developed a new skin eruption consisting of several ill-defined erythematous papules located symmetrically over the extensor surfaces of her arms. No pruritus, pain, or constitutional symptoms accompanied these skin lesions. In addition, the patient had no history of a known inciting exposure, significant sun exposure, or local trauma. She had no past history of photosensitivity, dermatoses, smoking, or rheumatic disease.The skin lesions progressed over the subsequent weeks, though the patient remained otherwise asymptomatic. At the assessment preceding the patient's 5th cycle of nab-paclitaxel, the skin eruption was noted to have progressed dramatically. Physical examination now showed a symmetrical, photodistributed rash involving the extensor surfaces of both arms and hands, as well as the anterior chest (Figure 1). The skin lesions were psoriasiform and consisted of erythematous papules coalescing into plaques with overlying scale (Figure 2). No demonstrable mucous membrane involvement, nail changes, or other skin lesions were evident. The remainder of the physical examination was remarkable only for findings of the known breast cancer.The current eruption was felt, clinically, to be in keeping with subacute cutaneous lupus erythematosus (scle). Upon review, the patient was not taking any medications known to be associated with scle. Her chronic medications included losartan, atorvastatin, and pantoprazole. In addition to nabpaclitaxel, she had recently used metoclopramide as needed for nausea. ABSTRACTDrug-induced lupus erythematosus (dile) syndromes are documented complications of chemotherapeutic agents, including paclitaxel. Subacute cutaneous lupus erythematosus (scle) is a distinct dile syndrome presenting with characteristic annular or papulosquamous skin lesions in a photosensitive distribution with associated high anti-ssa titres. Previously, dile syndromes complicating paclitaxel therapy have been attributed to polyethoxylated castor oil (Kolliphor EL: BASF, Ludwigshafen, Germany), the biologic solvent included in the drug's original formulation (Taxol: Bristol-Myers Squibb, Montreal, QC), rather than the parent chemotherapy molecule. Here, we report a characteristic case of drug-induced scle complicating treatment with nanoparticle albumin bound (nab)-paclitaxel (Abraxane: Celgene, Summit, NJ, U.S.A.), a solvent-free taxane formulation. The pertinent English-language literature is also discussed. This case report is the first to link solvent-free paclitaxel with scle, and it suggests that the parent molecule is respo...

show abstract

Drug-Induced, Ro/SSA-Positive Cutaneous Lupus Erythematosus

Cited by 143 publications

References 39 publications

Padrões de imunofluorescência do fator antinuclear (FAN) em células HEp-2 de soros reagentes para anti-SSA/Ro

Padrões de imunofluorescência do fator antinuclear (FAN) em células HEp-2 de soros reagentes para anti-SSA/Ro

Anti-thyroid drug-induced lupus: a case report and review of the literature

Drug-Induced Subacute Cutaneous Lupus Erythematosus Associated with Nab-Paclitaxel Therapy

Contact Info

Product

Resources

About