Development of systemic sclerosis in a patient with systemic lupus erythematosus and topoisomerase I antibody.
We describe a patient with systemic lupus erythematosus (SLE) associated with topoisomerase I (topo I, Scl-70) antibody, a specific marker for systemic sclerosis (SSc). SSc patients who produce this antibody have severe cutaneous and visceral involvement, and eventually have a poor prognosis. It is rare to find this antibody in patients with other collagen diseases. Only four SLE patients have been reported in the English language literature who were topo I antibody-positive but had no clinical evidence of scleroderma. The serum of our patient with SLE had precipitating topo I antibody from the onset of his disease. Twelve years after the onset of SLE, he developed proximal scleroderma and pulmonary fibrosis. This case reconfirms the prognostic significance of topo I antibody as a predictive marker, and indicates that SLE patients with topo I antibody require careful follow-up for future development of scleroderma.
Katsumi
S
S
Department of Dermatology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan. katsumis@naramed-u.ac.jp
Kobayashi
N
N
Yamamoto
Y
Y
Miyagawa
S
S
Shirai
T
T
D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D004264:DNA Topoisomerases, Type I / Q000276:immunology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology*; D008297:Male; D011237:Predictive Value of Tests; D012595:Scleroderma, Systemic / Q000209:etiology / Q000276:immunology*
D000974:Antibodies, Antinuclear; D015415:Biomarkers; D004264:DNA Topoisomerases, Type I