Abstract
Morphea is a disease that affects connective tissue and microvessels. Its pathogenesis is unknown, but several autoimmune factors participate. Our objective was to determine the frequency of antinuclear antibodies (ANAs) in pediatric patients with morphea and to establish their relation with the clinical variants and disease activity. A cross-sectional study was carried out from January 1999 to January 2008 in patients with morphea seen at the Instituto Dermatologico de Jalisco. ANAs were determined through an indirect immunoflourescent method, and the immunospecificity was done with a double immunodiffusion technique in agarose gel. A total of 34 children were included in the study, 74% of the female gender. Plaque morphea was the most common variant, present in 44% of the cases, followed by linear morphea in 38%, and generalized morphea in 18%. ANAs were positive in 29%, with homogenous immunoflourescense as the most frequent pattern (70%). Of the ANA-positive patients, 83% had generalized morphea, and in 70% of the cases the disease were considered as active. The frequency of ANA-positive children with morphea was 29%, and seems to be related to more extensive disease. No previous studies exist on this topic in the mestizo Mexican population.
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References
Peterson LS, Nelson AM, Su WP (1995) Classification of morphea (localized scleroderma). Mayo Clin Proc 70:1068–1076
Zulian F, Athreya BH, Laxer R et al (2006) Juvenile localized scleroderma: clinical and epidemiological features in 750 children. An International Study. Rheumatology (Oxford) 45:614–620
El-Azhary RA, Aponte CC, Nelson AM, Weaver AL, Homburguer HA (2006) Antihistone antibodies in linear scleroderma variants. Int J Dermatol 45:1296–1299
Christen-Zaech S, Hakim MD, Afsar FS, Paller AS (2008) Pediatric morphea (localized scleroderma): review of 136 patients. J Am Acad Dermatol 59:385–396
Sgonc R, Gruschwitz MS, Dietrich H, Recheis H, Gershwin ME, Wick G (1996) Endothelial cell apoptosis is a primary pathogenetic event underlying skin lesions in avian and human scleroderma. J Clin Invest 98:785–792
Kahaleh MB, Sherer GK, LeRoy EC (1979) Endothelial injury in scleroderma. J Exp Med 149:1326–1335
Herron GS, Ll R (1998) Vascular abnormalities in scleroderma. Sem Cutan Med Surg 17:12–17
Casciola-Rosen L, Wigley F, Rosen A (1997) Scleroderma autoantigens are uniquely fragmented by metal-catalyzed oxidation reactions: implications for pathogenesis. J Exp Med 185:71–79
Hatamochi A, Ono M, Arakawa M, Takeda K, Ueki H (1992) Analysis of collagen gene expression by cultured fibroblasts in morphoea. Br J Dermatol 126:216–221
Uziel Y, Krafchik BR, Silverman ED, Thorner PS, Laxer RM (1994) Localized scleroderma in childhood: a report of 30 cases. Semin Arthritis Rheum 23:328–340
Rosenberg AM, Uziel Y, Krafchik BR, Hauta SA, Prokopchuk PA, Silverman ED, Laxer RM (1995) Antinuclear antibodies in children with localized scleroderma. J Rheumatol 22:2337–2343
Blaszczyk M, Janniger CK, Jablonska S (1996) Childhood scleroderma and its peculiarities. Cutis 58(141–144):148–152
Sato S, Fujimoto M, Ihn H, Kikuchi K, Takehara K (1994) Clinical characteristics associated with antihistone antibodies in patients with localized scleroderma. J Am Acad Dermatol 31:567–571
Marzano AV, Menni S, Parodi A, Borghi A, Fuligni A, Fabbri P, Caputo R (2003) Localized scleroderma in adults and children. Clinical and laboratory investigations on 239 cases. Eur J Dermatol 13:171–176
Bodemer C, Belon M, Hamel-Teillac D, Amoric JC, Fraitag S, Prieur AM, De Prost Y (1999) Scleroderma in children: retrospective study of 70 cases. Ann Dermatol Venereol 126:691–694
Fontan I, Taieb A, Guillet G, Rommel A, Fontan D, Maleville J (1988) Immunologic changes in linear scleroderma in children. A propos of 11 cases. Ann Dermatol Venereol 115:135–141
Takehara K, Moroi Y, Nakabayashi Y, Ishibashi Y (1983) Antinuclear antibodies in localized scleroderma. Arthritis Rheum 26:612–616
Falanga V, Medsger TA Jr, Reichlin M (1987) Antinuclear and anti-single-stranded DNA antibodies in morphea and generalized morphea. Arch Dermatol 123:350–353
Larregue M, Ziegler JE, Lauret P, Bonafe J, Lorette G, Titi A, Ramdenee P, Bressieux JM (1986) Linear scleroderma in children (a propos of 27 cases). Ann Dermatol Venereol 113:207–224
Bernstein RM, Pereira RS, Holden AJ, Black CM, Howard A, Ansell BM (1985) Autoantibodies in childhood scleroderma. Ann Rheum Dis 44:503–506
Leitenberger JJ, Cayce RL, Haley RW, Adams-Huet B, Bergstresser PR, Jacobe HT (2009) Distinct autoimmune syndromes in morphea. A review of 245 adult and pediatric cases. Arch Dermatol 145:545–550
Tuffanelli DL (1998) Localized scleroderma. Semin Cutan Med Surg 17:27–33
Bottoni CR, Reinker KA, Gardner RD, Person DA (2000) Scleroderma in childhood: a 35-year history of cases and review of the literature. J Pediatr Orthop 20:442–449
Solomon DH, Kavanaugh AJ, Schur PH (2002) American College of Rheumatology Ad Hoc Committee on Immunologic Testing. Evidence-based guidelines for the use of immunologic tests: antinuclear antibody testing. Arthritis Rheum 47:434–444
Mutasim D, Adams BB (2000) A practical guide for serologic evaluation of autoimmune connective tissue diseases. J Am Acad Dermatol 42:159–174
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Guevara-Gutiérrez, E., Yinh-Lao, J., García-Gutiérrez, P. et al. Frequency of antinuclear antibodies in mestizo Mexican children with morphea. Clin Rheumatol 29, 1055–1059 (2010). https://doi.org/10.1007/s10067-010-1515-2
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DOI: https://doi.org/10.1007/s10067-010-1515-2