Systemic Lupus Erythematosus and Dna Antibodies in Pleural Effusions

Abstract

The quantity of antibodies to double-stranded DNA (ds-DNA) in 53 pleural effusions from 48 patients was measured by means of a modified Farr technique. In 10 samples, binding of ds-DNA was greater than 5 mg/l (range 6--14 mg/l), five samples being from patients with systemic lupus erythematosus (SLE), four from patients with lung cancer, and one from a patient with pulmonary tuberculosis. After treatment of pleural effusion samples with DNase, there was a marked increase of ds-DNA binding in the SLE group (n = 5), but none in the lung cancer group (n = 7) or in 4 patients with pleural effusions of various origin. In pleural fluid, demonstration of antibodies to ds-DNA and anti-ds-DNA-ds-DNA complexes, unmasked by DNase, may prove valuable when differentiating clinical conditions with pleural effusions.

Clinical and Pathologic Features of Lung Involvement in Systemic Lupus Erythematosus

“…The nature of the immune complexes in SLE pleural fluid is not clear. Riska and associates 28 noted that the enzymatic digestion of SLE pleural fluid with deoxyribonuclease resulted in an increase of anti-DNA antibody titer. This observation suggests that DNA-anti-DNA complexes participate in the formation of pleural fluid immune complexes.…”

Pleural Involvement in Systemic Autoimmune Disorders

“…Most patients with SLE also have higher ANA titers for ssDNA, dsDNA, smooth muscle and ribonucleoprotein [78, 79], although demonstrable pleural fluid ANAs are occasionally absent [80]. In SLE patients in which ANA titers tend to be low or absent, pleural fluid ANA titer levels may be useful in distinguishing between lupus pleuritis and other causes of pleural disease [81].…”

Systemic lupus erythematosus presenting as right-sided massive pleural effusion with autoimmune hypothyroidism and medium vessel vasculopathy

“…Antinuclear antibodies, anti-DNA antibodies and lupus erythematosus cells are usually found in the pleural fluid. Lupus erythematosus cells appear to be relatively specific 6–9. Pleural biopsies have rarely been performed in SLE, and are primarily indicated to rule out alternative causes.…”