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Rheumatology International

, Volume 38, Issue 7, pp 1169–1178 | Cite as

The impact of anti-U1-RNP positivity: systemic lupus erythematosus versus mixed connective tissue disease

  • Alina DimaEmail author
  • Ciprian Jurcut
  • Cristian Baicus
Review

Abstract

Anti-U1-RNP positivity remains mandatory for the mixed connective tissue disease (MCTD) diagnosis, reason for which anti-U1-RNP occurrence in patients with lupus clinical features might determine diagnostic issues. Thus, the prevalence of 25–30% for anti-RNP was reported in John Hopkins and LUMINA lupus cohorts and also 13% prevalence for the anti-U1-RNP in Euro-Lupus cohort. Presence of anti-U1-RNP antibodies in patients fulfilling SLE criteria (but not the MCTD ones) was associated with manifestations such as Raynaud phenomenon, musculoskeletal and lung impairment or nail fold capillaroscopy changes, some clinical features frequently encountered in MCTD patients and only rarely described in lupus population. The use of more specific markers such as 70 kDa anti-U1-RNP or anti-Sm-D was proposed for discriminating between SLE and MCTD. In addition, the IgM serotype of anti-U1-RNP seems more frequently expressed in SLE, while the IgG serotype alone in MCTD. Better acknowledgement of possible clinical involvements in lupus subsets, such as the peculiarities related to the anti-U1-RNP positivity, could provide access to early diagnosis of rather rare but possible severe lupus organ impairments (e.g. pulmonary arterial hypertension).

Keywords

U1 RNP U1 70 k Systemic lupus erythematosus Criteria MCTD Scleroderma 

Abbreviations

ACR

American College of Rheumatology

ANA

Antinuclear antibodies

CL

Cardiolipin

CTD

Connective tissue diseases

DCTD

Diffuse connective tissue disease

DM

Dermatomyositis

ENA

Extractable nuclear antigen

IIF

Indirect immunofluorescence

ILE

Incomplete lupus erythematosus

LAC

Lupus anticoagulant

MCTD

Mixed connective tissue disease

RP

Raynaud phenomenon

RNP

Ribonucleoproteins

SLE

Systemic lupus erythematosus

SLICC

Systemic Lupus International Collaborative Clinics

SSc

Systemic sclerosis

U

Uridin

UCTD

Undifferentiated connective tissue disease

Notes

Author contributions

AD, CJ and CB conception and design. AD data acquisition. AD, CJ and CB analyzing and interpretation data. AD and CJ drafting the manuscript. CB revising the manuscript. AD, CJ and CB approval of the manuscript final version.

Funding

No specific grant from any public agency, commercial or not-for-profit sectors was received for the presented research.

Compliance with ethical standards

Conflict of interest

None of the authors received any fees, honoraria, grants or consultancies that would constitute a conflict of interest with the current study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Internal Medicine DepartmentCarol Davila University of Medicine and PharmacyBucharest S2Romania
  2. 2.Internal Medicine DepartmentCarol Davila Central University Emergency Military HospitalBucharest S2Romania
  3. 3.Internal Medicine Department, Colentina Research CenterColentina Clinical HospitalBucharest S2Romania

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