Anti-Sm antibodies in the classification criteria of systemic lupus erythematosus

Beers, Joyce J B C van; Schreurs, Marco W. J.

doi:10.1016/j.jtauto.2022.100155

Cited by 13 publications

(6 citation statements)

References 58 publications

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“…Although our patient did not exhibit a typical full-house pattern of immunoglobulin deposition in the glomerular basement membrane or any symptoms suggesting autoimmune diseases, including systemic lupus erythematosus or Sjögren's syndrome, he may have had an underlying autoimmune disease or overlapping syndrome because he was positive for anti-Sm and anti-SS-A antibodies even after 5 years post-eradication of his gastric Helicobacter pylori . The anti-Sm antibody is specific for systemic lupus erythematosus; however, its sensitivity is restricted [ 18 ]. The clinical significance of anti-Sm antibodies is still under debate.…”

Section: Discussionmentioning

confidence: 99%

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Successful treatment of coexisting membranous nephropathy and immune thrombocytopenia by eradicating gastric Helicobacter pylori infection: a case report

Suetsugu,

Sakuma,

Maruyama

et al. 2023

CEN Case Rep

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Membranous nephropathy (MN) is a common cause of nephrotic syndrome in middle-aged and older adults. MN etiology is mainly primary or idiopathic; however, it may also be secondary to infections, drugs, neoplasms, and autoimmune diseases. We present the case of a 52-year-old Japanese man with coexisting nephrotic MN and immune thrombocytopenic purpura (ITP). Renal biopsy revealed glomerular basement membrane thickening with immunoglobulin (Ig) G and complement component 3 deposition. Glomerular IgG subclass analysis revealed predominant IgG4 deposition with weak IgG1 and IgG2 deposition. IgG3 and phospholipase A2 receptor deposits were negative. Upper endoscopy revealed no ulcers, but histological examination demonstrated Helicobacter pylori infection in the gastric mucosa with elevated IgG antibodies. After gastric Helicobacter pylori eradication, the nephrotic-range proteinuria and thrombocytopenia of the patient were markedly improved without initiation of immunosuppressive treatment. Therefore, clinicians should consider the possibility of Helicobacter pylori infection in patients with coexisting MN and ITP. Further studies are required to demonstrate the associated pathophysiological aspects.

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Section: Discussionmentioning

confidence: 99%

“…The clinical significance of anti-Sm antibodies is still under debate. Furthermore, although we must monitor our patient for the possibility of late-onset systemic lupus erythematosus [ 18 ] or overlap syndrome [ 19 ], we successfully treated coexisting MN and ITP with gastric Helicobacter pylori eradication.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of coexisting membranous nephropathy and immune thrombocytopenia by eradicating gastric Helicobacter pylori infection: a case report

Suetsugu,

Sakuma,

Maruyama

et al. 2023

CEN Case Rep

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“…To summarize the immunology workup, ENA was high with negative anti-Ro/SS-A and anti-La/SS-B and positive Sm/RNP with negative anti-smith (anti-Sm) antibody. Sm/RNP is also known as U1-small nuclear RNP (U1-SnRNP) complex ( Figure 2 ) ( 3 ). It is an ENA and is a complex protein consisting of both anti-Sm and anti-RNP.…”

Section: Discussionmentioning

confidence: 99%

“… U1-SnRNP complex. Photograph obtained from an open-access article distributed under the Creative Commons Attribution License ( 3 ). …”

Section: Discussionmentioning

confidence: 99%

Anti-U1RNP-70kD-positive case of neonatal lupus presenting with seizure and incomplete heart block: a case report and literature review

Alfalasi,

ElGhazali,

Fathalla

et al. 2023

Front. Pediatr.

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Neonatal lupus erythematosus (NLE) is an autoimmune disease caused by the transplacental passage of anti-Ro/SS-A and anti-La/SS-B. This can be less commonly seen with U1-ribonucleoprotein (U1RNP). Our patient is a 7-day-old male, who first presented with seizures. In addition, during an electroencephalogram, he was found to have an irregular heart rhythm. Looking further into the history, we found that the mother was aware that she had systemic lupus erythematosus (SLE). However, she had not been followed up with a rheumatologist. The workup for NLE found a negative anti-Ro/SS-A and anti-La/SS-B, with a positive U1RNP-70kD. U1RNP-70kD is a diagnostic test for mixed connective tissue disease in adults, but no research has been done on its significance in NLE. Despite having SLE, the infant’s mother did not receive surveillance during her pregnancy, as the current guidelines are tailored for mothers with anti-Ro/SS-A and anti-La/SS-B. As a result, this calls for the extension of these guidelines to include the U1RNP-70kD antibody. In this case, the 70kD subtype of U1RNP was positive, which may have had a role to play in this unusual presentation. However, further research is needed to improve the care of mothers and babies with U1RNP-70kD.

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“…Interestingly ANA speckled pattern was associated with mild-moderate SLE. Usually, speckled pattern is generated by the anti-Sm antibody (34) that is associated with severe SLE (35). However, none of the antibodies were associated with severe SLE in our cohort except aCL (OR 2.4; 95% CI 1.0-5.9).…”

Section: Discussionmentioning

confidence: 99%

Remission and clinical patterns of systemic lupus erythematosus (SLE) in Pakistan: a retrospective cohort study

Saeed¹,

Pasha

Rizvi³

et al. 2022

Preprint

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ObjectivesPrimary objective was to investigate clinical features and biomarkers associated with severe systemic lupus erythematosus (SLE). The secondary objective was to identify patterns of SLE remission. ’MethodsA retrospective study of 200 SLE patients (2014–20) from ImmunoCure Center was conducted. Patients fulfilled ACR criteria 1997 for SLE classification. SLEDAI-2K categories mild-moderate (score <=10) and severe (score >10) were used as outcome for the primary objective. Predictors of severe SLE were evaluated by multivariate logistic regression analysis. For the secondary objective, we evaluated 94 records with follow-up time >1year. Remission status (Yes/No) was based on DORIS criteria. Survival regression was performed using Kaplan Meier curve.ResultsSignificant predictors of severe SLE were male gender (OR 4.1; 95% CI: 1.2, 13.5), oral ulcers (OR 6.9; 95% CI: 2.8, 17.1), alopecia (OR 2.1; 95% CI 1.0-4.1), nephritis (OR 4.5; 95% CI: 1.9-11.4), ESR >30mm/hour (OR 2.3; 95% CI: 1.2-4.4) and aCL antibodies (OR 2.4, 95% CI 1.0 -5.9). The mean duration of follow-up was 41±19 months. Remission on treatment was achieved in 66% of 94 patients, while off treatment in 21% with a mean post-remission follow-up of 18±15 months. For every one-month increase in the duration of follow-up, the hazard of time to remission increased by 4% (95% CI 0.95-0.98;P<0.001). Factor analysis identified 4 SLE subtypes.ConclusionA clinical model including aCL antibodies is presented here that predicts severe SLE. Remission is possible even in severe SLE in LMIC with adequate immunosuppression and persistent follow-up.

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Anti-Sm antibodies in the classification criteria of systemic lupus erythematosus

Cited by 13 publications

References 58 publications

Successful treatment of coexisting membranous nephropathy and immune thrombocytopenia by eradicating gastric Helicobacter pylori infection: a case report

Successful treatment of coexisting membranous nephropathy and immune thrombocytopenia by eradicating gastric Helicobacter pylori infection: a case report

Anti-U1RNP-70kD-positive case of neonatal lupus presenting with seizure and incomplete heart block: a case report and literature review

Remission and clinical patterns of systemic lupus erythematosus (SLE) in Pakistan: a retrospective cohort study

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