Erosive arthritis in systemic lupus erythematosus: analysis of a distinct clinical and serological subset

Br J Rheumatol. 1998 Apr;37(4):421-4. doi: 10.1093/rheumatology/37.4.421.

Abstract

Erosive arthritis (EA) in systemic lupus erythematosus (SLE) can be debilitating and deforming with uncertain factors for risk, although antibodies to the A2 hnRNP core protein, known as anti-RA33, have been associated with EA. Two hundred patients under long-term follow-up for SLE were evaluated for EA and associated clinical and serological abnormalities. In addition, sera were tested in a masked fashion for anti-RA33 antibodies in a total of 60 patients: 10 with EA and 50 age-, sex- and ethnically matched controls. Ten of 200 (5%) patients with SLE, mainly non-white women, had EA. There were trends for increased renal involvement (P = 0.06), Sjögren's syndrome (P = 0.07) and Raynaud's phenomenon (P = 0.03) in patients with EA compared to those without EA. Rheumatoid factor (RF) was increased in patients with EA (P < 0.02), as were antibodies to double-stranded DNA (P < 0.05), Sm (P < 0.01) and La/SS-B (P < 0.001). Anti-RA33 antibodies were present in 70% with EA compared to 28% without EA (P < 0.05). RF correlated with anti-RA33 antibodies in patients with EA, but not with the presence of anti-RA33 alone. Thus, anti-RA33 antibodies may identify those patients with SLE who are at risk for EA, and an association with RF suggests a common immune response or pathological mechanism in autoimmune erosive joint disease.

MeSH terms

  • Antibodies, Antinuclear / blood*
  • Arthritis / ethnology
  • Arthritis / immunology*
  • Arthritis / mortality*
  • Asian People
  • Autoantigens / immunology
  • Black People
  • Female
  • HeLa Cells
  • Heterogeneous-Nuclear Ribonucleoprotein Group A-B*
  • Heterogeneous-Nuclear Ribonucleoproteins
  • Humans
  • Lupus Erythematosus, Systemic / ethnology
  • Lupus Erythematosus, Systemic / immunology*
  • Lupus Erythematosus, Systemic / mortality*
  • Male
  • RNA, Small Cytoplasmic*
  • Ribonucleoproteins / immunology
  • Risk Factors
  • White People

Substances

  • Antibodies, Antinuclear
  • Autoantigens
  • Heterogeneous-Nuclear Ribonucleoprotein Group A-B
  • Heterogeneous-Nuclear Ribonucleoproteins
  • RNA, Small Cytoplasmic
  • RO60 protein, human
  • Ribonucleoproteins
  • SS-A antigen
  • SS-B antigen
  • hnRNP A2