Clinical significance of anti-Sm antibodies in systemic lupus erythematosus

Am J Med. 1983 Feb;74(2):201-5. doi: 10.1016/0002-9343(83)90612-5.

Abstract

Case records of 34 patients with systemic lupus erythematosus (SLE) were analyzed. Twelve patients had both anti-DNA and anti-Sm antibodies (Group I) and 22 had anti-DNA antibodies only (Group II). The disease patterns were comparable, except for (1) cutaneous vasculitis, which was observed in six of 12 patients in Group I and one of 22 in Group II (p less than 0.01); (2) pulmonary manifestations, nine of 12 in Group I and two of 22 in Group II (p less than 0.001); (3) cardiac manifestations, eight of 12 in Group I and four of 22 in Group II (p less than 0.01); and (4) renal biopsy, which showed milder lesions in Group I than in Group II (p less than 0.05). Evolution was fatal in four patients in Group I and in none in Group II. It is suggested that in SLE, the presence of anti-Sm antibody is associated with a much higher incidence of vasculitis, resulting in peculiar visceral manifestations, which can be poorly responsive to therapy. Whether there is a direct association between anti-Sm antibody and vasculitis or whether the common denominator is a genetic selection remains to be determined.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Antibodies / analysis*
  • Antibodies, Antinuclear / analysis
  • Antigens / immunology*
  • Autoantigens
  • DNA / immunology
  • Female
  • Heart Diseases / etiology
  • Humans
  • Kidney Diseases / etiology
  • Lung Diseases / etiology
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / immunology*
  • Male
  • Nervous System Diseases / etiology
  • Retrospective Studies
  • Ribonucleoproteins, Small Nuclear*
  • Skin Diseases / etiology
  • Vasculitis / etiology
  • snRNP Core Proteins

Substances

  • Antibodies
  • Antibodies, Antinuclear
  • Antigens
  • Autoantigens
  • Ribonucleoproteins, Small Nuclear
  • snRNP Core Proteins
  • DNA