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Clinical setting of patients with systemic sclerosis by serum autoantibodies

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Summary

Associations of antinuclear (ANA) and anticardiolipin (aCL) antibodies with clinical manifestations were analyzed in patients with systemic sclerosis (SSc).

We studied 105 SSc patients: 28 had limited cutaneous SSc (IcSSc) involving fingers; 36 had intermediate cutaneous SSc involving limbs and face; 33 had diffuse cutaneous SSc (dcSSc) involving the trunk; 8 had a sclerosis sine scleroderma. Clinical manifestations and instrumental and laboratory findings were considered to calculate a disease score. Serum anticentromere (ACA), anti-topoisomerase I (anti-topo I) antibodies, and aCL (of IgG/IgA/IgM classes) were investigated by conventional methods. ACA positive patients (n=18), compared to ACA negative, showed higher prevalence of IcSSc (p < 0.001), lower prevalence of restrictive ventilatory defect (p=0.006), and lower disease score (p=0.008). Anti-topo I positive patients (n=70) showed lower prevalence of IcSSc (p=0.001) compared to anti-topo I negative. In aCL positive patients (n=27) widespread skin and visceral involvement occurred more frequently than in aCL negative. The association with myocardial ischemia or necrosis (p=0.010) was significant. Occurrence of ACA excluded the coexistence of anti-topo I (p<0.001), and aCL (p=0.037). aCL positive patients showed higher disease score in comparison with ACA positive patients (p=0.003). In conclusion ACA recognize patients with a mild disease. aCL in contrast to ACA are better than anti-topo I in recognizing the most severe pictures of SSc.

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Authors and Affiliations

  1. From the Institute of Clinical Medicine, Rheumatology Unit, Faculty of Medicine 2nd University of Naples, Via S. Pansini, 5, I-80131, Naples, Italy

    U. Picillo M.D., S. Migliaresi, M. R. Marcialis, A. M. Ferruzzi & G. Tirri

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  2. S. Migliaresi
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  3. M. R. Marcialis
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  4. A. M. Ferruzzi
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  5. G. Tirri
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Picillo, U., Migliaresi, S., Marcialis, M.R. et al. Clinical setting of patients with systemic sclerosis by serum autoantibodies. Clin Rheumatol 16, 378–383 (1997). https://doi.org/10.1007/BF02242455

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