Clinical and autoimmune profile of scleroderma patients from Western India.
Background. Systemic sclerosis (SSc, scleroderma) is a disorder characterized by fibrosis of skin and visceral organs. Pathogenesis of scleroderma is complex and is incompletely understood as yet. Autoantibodies in SSc represent a serologic hallmark which have clinical relevance, with diagnostic and prognostic potential. Objectives. To study distribution of clinical manifestations and to identify frequency of autoantibodies among subtypes of scleroderma patients from Western India. Methodology. One hundred and ten scleroderma patients were clinically classified according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria. All these patients were in active stage of disease. Clinical manifestations were recorded at the time of presentation. Autoantibodies were tested in them by indirect immunofluorescence test and ELISA. Immunoglobulin levels were estimated by nephelometer. These parameters were further correlated with clinical presentation of the disease. Results. Scleroderma patients had M : F ratio of 1 : 10 where mean age at evaluation was 34.7 ± 10.7 years and a mean disease duration was 43.7 ± 35 months. Clinical subtypes showed that 45 patients (40.9%) had diffused cutaneous (dcSSc) lesions, 32 patients (29.1%) had limited cutaneous (lcSSc) lesions, and 33 patients (30%) had other autoimmune overlaps. The overall frequency of ANA in SSc patients studied was 85.5%. The frequency of anti-Scl70, anti-centromere, anti-endothelial cell antibodies (AECA), and anti-keratinocyte antibodies (AKA) was 62.7%, 22.7%, 30%, and 40.9%, respectively. Anti-Scl70 antibodies were significantly high (75.6% versus 46.9%) among dcSSc patients (P < 0.0115) whereas anti-centromere antibodies were significantly high (9% versus 38%) among lcSSc patients when these two subtypes were compared (P < 0.0044). Conclusion. This study supports that there are geoepidemiological variations among scleroderma patients for their clinical presentation, autoantibody profile, and immune parameters across the country.
National Institute of Immunohaematology, Parel, Mumbai 400012, India.
Vandana
V
Pradhan
Department of Medicine, King Edward Memorial Hospital, Parel, Mumbai 400012, India.
Anjali
A
Rajadhyaksha
Department of Medicine, King Edward Memorial Hospital, Parel, Mumbai 400012, India.
Milind
M
Nadkar
National Institute of Immunohaematology, Parel, Mumbai 400012, India.
Pallavi
P
Pandit
National Institute of Immunohaematology, Parel, Mumbai 400012, India.
Prathamesh
P
Surve
Institut National de la Santé et de la Recherche Médicale Unité 1138, Centre de Recherche des Cordeliers, UPMC Univ Paris 06, 75006 Paris 6, France.
Maxime
M
Lecerf
Institut National de la Santé et de la Recherche Médicale Unité 1138, Centre de Recherche des Cordeliers, UPMC Univ Paris 06, 75006 Paris 6, France.
Jagadeesh
J
Bayry
Institut National de la Santé et de la Recherche Médicale Unité 1138, Centre de Recherche des Cordeliers, UPMC Univ Paris 06, 75006 Paris 6, France.
Srinivas
S
Kaveri
National Institute of Immunohaematology, Parel, Mumbai 400012, India.
Kanjaksha
K
Ghosh