Undifferentiated connective tissue disease with antibodies to Ro/SSa: clinical features and follow-up of 148 patients

Clin Exp Rheumatol. Jul-Aug 2001;19(4):403-9.

Abstract

Objective: To evaluate the clinical and serologic profile, the rate of progression to well defined CTD and the possible predictors of disease evolution in patients affected by UCTD with antibodies anti-RoISSA.

Methods: 148 patients diagnosed as UCTD were retrospectively evaluated. Antibodies to SSA/Ro were determined by counter-immunoelectrophoresis and ELISA.

Results: Thirty-six patients (24.3%) developed a well-defined CTD after a mean follow-up of 4.5 years. Most patients developed primary Sjögren's syndrome (SS) (50%) or systemic lupus erythematosus (SLE) (30.5%). Leukopenia and xerophthalmia developed more frequently in the group of patients evolving to defined CTDs (p < 0.0032 and p < 0.0063). Leukopenia independently predicted the evolution in CTD by multivariate regression analysis (p < 0.019). Anti-dsDNA predicted the evolution in SLE (p < 0.0207), while the presence of additional anti-ENA specificity to anti-Ro/SSA was not associated with the outcome.

Conclusion: 24.3% of patients with UCTD and antibodies to Ro/SSA can progress in a relatively short period of time to well-defined CTDs. The development of primary SS could be predicted by xerophthalmia and SLE by the appearance of anti-dsDNA antibodies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Antinuclear / blood
  • Arthralgia / etiology
  • Arthralgia / pathology
  • Autoantigens / blood*
  • Child
  • Disease Progression
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoelectrophoresis
  • Interleukin-8 / analogs & derivatives*
  • Interleukin-8 / immunology
  • Leukopenia / etiology
  • Leukopenia / pathology
  • Lupus Erythematosus, Systemic / etiology
  • Lupus Erythematosus, Systemic / pathology
  • Male
  • Middle Aged
  • Mixed Connective Tissue Disease / complications
  • Mixed Connective Tissue Disease / diagnosis*
  • Mixed Connective Tissue Disease / immunology*
  • Mixed Connective Tissue Disease / physiopathology
  • RNA, Small Cytoplasmic*
  • Retrospective Studies
  • Ribonucleoproteins / blood*
  • Sjogren's Syndrome / etiology
  • Sjogren's Syndrome / pathology
  • Xerophthalmia / etiology
  • Xerophthalmia / pathology

Substances

  • Antibodies, Antinuclear
  • Autoantigens
  • Interleukin-8
  • RNA, Small Cytoplasmic
  • RO60 protein, human
  • Ribonucleoproteins
  • SS-A antigen
  • endothelial neutrophil activating peptide