Clinical implications of the presence of anti-Ro (SSA) antibodies in patients with rheumatoid arthritis.
The clinical and serologic findings in 25 patients with rheumatoid arthritis (RA) of more than 5 years' duration, who had antibodies to Ro(SSA) cellular antigen, were analyzed and compared with those in 50 anti-Ro(SSA) negative RA patients with similar disease duration. Ninety-six percent of the anti-Ro(SSA) positive patients were female, compared to 74% in the negative group. The majority of antibody positive patients had symmetric erosive synovitis, similar to that observed in the negative group. Extra-articular manifestations were similar in both groups, except for features of Sjögren's syndrome (keratoconjunctivitis sicca and positive labial salivary gland biopsy), which were significantly more common in patients with anti-Ro(SSA) antibodies. Anemia of chronic disease was also more common in these patients, as were rheumatoid factor (RF) and antinuclear antibodies (ANAs). No patient in either group had antibodies to ds-DNA or Sm and none developed clinical features suggestive of systemic lupus erythematosus (SLE). D-penicillamine, given in the majority of patients in both groups, produced adverse reactions in 72% of the anti-Ro(SSA) positive patients, but only in 27% of the negative ones. Thus, anti-Ro(SSA) antibodies seem to characterize a distinct group of RA patients who are almost exclusively female, express more activated B-cell function, have a high prevalence of Sjögren's features and commonly develop side effects to D-penicillamine.
Skopouli
F N
FN
Department of Internal Medicine, School of Medicine, University of Ioannina, Greece.
Andonopoulos
A P
AP
Moutsopoulos
H M
HM
D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000032:analysis*; D001172:Arthritis, Rheumatoid / Q000208:ethnology / Q000276:immunology*; D006115:Greece / Q000208:ethnology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000276:immunology; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects; D012859:Sjogren's Syndrome / Q000276:immunology
D000974:Antibodies, Antinuclear; C035356:SS-A antibodies; D010396:Penicillamine