ABSTRACT
Introduction: The presence of autoantibodies can occur years before clinical disease though their presence does not predict disease progression. Mothers enrolled in The Research Registry for Neonatal Lupus (RRNL) are an excellent opportunity to study disease progression, since all of these women are anti-Ro/La positive, and many are asymptomatic at the birth of an affected child. Materials and Methods: 99 mothers (32 percent) from the RRNL were studied, all of whom had been follow-up more than on year. They were classified in six different categories depending on the diagnosis made at the time of birth (Asymptomatic, Pauci-SLE, Pauci-SS, SS, SLE and SLE with secondary SS). The presence of the autoantibodies was confirmed by ELISA and Immunoblot assays. Results: 28.3 percent were asymptomatic at the time of birth, and 39.4 percent had already developed a few symptoms. Out of 67 mothers, 43.3 percent progressed to a clinical autoimmune disease after 8.3 years of follow-up. The most common progression of all the asymptomatic or pauci symptomatic mothers (n = 67) was towards SS (28.4 percent) after a follow-up of 5.4 years, and only 14.9 percent progressed to LES. The latter was seen later in time (8.7 years since birth). Antibody profile was neither useful as a progression biomarker nor as a diagnostic tool.