title: The high incidence of anti-Ro/SSA and anti-p200 antibodies in female patients with connective tissue diseases confirms the importance of screening for congenital heart block-associated autoantibodies during pregnancy.
abstract: It is known that anti-Ro/SSA positivity leads to higher risk of miscarriage and fetal cardiac malformations. Particularly, anti-p200 antibodies against a finer specificity of the Ro/SSA antigen, have been associated with congenital heart block. The aim of the study was to assess the frequency of anti-p200 among female patients with different connective tissue diseases and, among these, the relevance of anti-p200 values in patients with cutaneous diseases compared to systemic diseases. Anti-p200 were investigated in 110 anti-Ro/SSA positive female sera, sent to our laboratory between 2008 and 2014 with suspect of connective disease, by using ELISA testing. Positivity was found in 40.9 % samples, 34 of them showed a strong positivity (values ≥ 1.0, cut off = 0.7). Patients with systemic diseases were anti-p200 positive in the 45.9 % of cases while patients with cutaneous diseases were positive in the 24.0 % of cases. Positivity for anti-p200 antibodies was revealed in 24.0 % of patients with discoid lupus erythematosus; 100 % of patients with dermatomyositis; 40.0 % of patients with mixed connective tissue disease; 25.0 % of patients with rheumatoid arthritis; 100 % of patients with Sjögren's syndrome; 33.3 % of patients with subacute cutaneous lupus erythematosus; 42.9 % of patients with systemic lupus erythematosus; 80.0 % of patients with systemic sclerosis. No significant difference in anti-p200 prevalence was found between systemic and cutaneous involvement, nevertheless, considering only positive sera, the antibody titer was higher in systemic diseases rather than in cutaneous diseases (2.6 ± 1.7 and 1.7 ± 1.9; p = 0.041). The authors think screenings for anti-Ro/SSA and anti-p200 antibodies should be included in the laboratory checklist for pregnancy.
authors.affiliation: Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, 16132, Genoa, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Cozzani
authors.affiliation: Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, 16132, Genoa, Italy. a.agnoletti@virgilio.it.
authors.forename: Arianna Fay
authors.initials: AF
authors.lastname: Agnoletti
authors.affiliation: Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, 16132, Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pappalardo
authors.affiliation: Biostatistics Unit, Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Schiavetti
authors.affiliation: Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, 16132, Genoa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Torino
authors.affiliation: Section of Dermatology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, 16132, Genoa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Parodi
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D003240:Connective Tissue Diseases / Q000097:blood*; D005260:Female; D006327:Heart Block / Q000151:congenital* / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D011296:Prenatal Diagnosis / Q000379:methods*; D012261:Ribonucleoproteins / Q000276:immunology*; D055815:Young Adult; D000099207:SS-A Antigen
chemical_list: D001323:Autoantibodies; D012261:Ribonucleoproteins; D000099207:SS-A Antigen
keywords: Anti-Ro/SSA antibodies; Anti-p200 antibodies; Cardiac complications; Connective tissue disease; Pregnancy screening