Clinical significance of anti-Sm antibodies in systemic lupus erythematosus.
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.
D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000032:analysis*; D000974:Antibodies, Antinuclear / Q000032:analysis; D000941:Antigens / Q000276:immunology*; D001324:Autoantigens; D004247:DNA / Q000276:immunology; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology; D008171:Lung Diseases / Q000209:etiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology*; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology; D012189:Retrospective Studies; D017411:Ribonucleoproteins, Small Nuclear; D012871:Skin Diseases / Q000209:etiology; D014657:Vasculitis / Q000209:etiology; D055517:snRNP Core Proteins
D000906:Antibodies; D000974:Antibodies, Antinuclear; D000941:Antigens; D001324:Autoantigens; D017411:Ribonucleoproteins, Small Nuclear; D055517:snRNP Core Proteins; D004247:DNA