title: Relationship between autoantibody clustering and clinical subsets in SLE: cluster and association analyses in Hong Kong Chinese.
abstract: OBJECTIVE
  This study aims to identify the existence of, and relationship between autoantibody clusters and clinical subsets in Chinese SLE patients.
  
  
  METHODS
  Data from 1928 SLE patients from Hong Kong were analysed. Using cluster analysis, patients were grouped by autoantibodies into clusters. The frequencies of various clinical manifestations were then compared between each cluster. Separate association analyses between individual autoantibodies and clinical manifestations as well as between clinical manifestations were also performed without any prior clustering.
  
  
  RESULTS
  Three separate autoantibody clusters were identified, each with significantly different clinical manifestations. Cluster 1 was characterized by anti-dsDNA and the greatest prevalence of renal disorder but the lowest frequencies of other clinical manifestations. Cluster 2 was represented by the predominance of anti-Smith, anti-RNP and aPL, with greater prevalence of malar rash, oral ulcers, arthritis and serositis. Cluster 3 was characterized by anti-Ro and anti-La with greater prevalence of discoid rash, photosensitivity and haematological involvement. Individual association analysis also revealed similar findings. Patients of clusters 2 and 3 were more closely related, while cluster 1 was more distinct, associated with renal disorder only and negatively associated or not associated with other manifestations.
  
  
  CONCLUSIONS
  We conclude that autoantibody clustering and clinical subsets exist in SLE patients of our locality. These clusters may be viewed as a bipolar spectrum of related autoantibody and clinical manifestations. At one end are patients with over-representation of anti-dsDNA and renal disorder, while at the other end are two distinct autoantibody clusters (anti-Sm/anti-RNP/aPL and anti-Ro/anti-La) with overlapping of other clinical manifestations.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: Philip Hei
authors.initials: PH
authors.lastname: Li
authors.forename: Wilfred Hing Sang
authors.initials: WH
authors.lastname: Wong
authors.forename: Tsz Leung
authors.initials: TL
authors.lastname: Lee
authors.forename: Chak Sing
authors.initials: CS
authors.lastname: Lau
authors.forename: Tak Mao
authors.initials: TM
authors.lastname: Chan
authors.forename: Alexander Moon Ho
authors.initials: AM
authors.lastname: Leung
authors.forename: Kwok Lung
authors.initials: KL
authors.lastname: Tong
authors.forename: Niko Kei Chiu
authors.initials: NK
authors.lastname: Tse
authors.forename: Chi Chiu
authors.initials: CC
authors.lastname: Mok
authors.forename: Sik Nin
authors.initials: SN
authors.lastname: Wong
authors.forename: Ka Wing
authors.initials: KW
authors.lastname: Lee
authors.forename: Marco Hok Kung
authors.initials: MH
authors.lastname: Ho
authors.forename: Pamela Pui Wah
authors.initials: PP
authors.lastname: Lee
authors.forename: Chun Yin
authors.initials: CY
authors.lastname: Chong
authors.forename: Raymond Woon Sing
authors.initials: RW
authors.lastname: Wong
authors.forename: Mo Yin
authors.initials: MY
authors.lastname: Mok
authors.forename: Shirley King Yee
authors.initials: SK
authors.lastname: Ying
authors.forename: Samuel Ka Shun
authors.initials: SK
authors.lastname: Fung
authors.forename: Wai Ming
authors.initials: WM
authors.lastname: Lai
authors.forename: Wanling
authors.initials: W
authors.lastname: Yang
authors.forename: Yu-Lung
authors.initials: YL
authors.lastname: Lau
mesh_terms: D000293:Adolescent; D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D044466:Asian People / Q000208:ethnology; D001323:Autoantibodies / Q000097:blood*; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000208:ethnology / Q000276:immunology*; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies