Anti-La negative cutaneous lupus erythematosus in a newborn.

A newborn presented with erythematous lesion over face, which appeared soon after birth. Diagnosis of neonatal lupus erythematosus (NLE) was confirmed by positive anti-Ro SSA antibody and skin biopsy. But anti-La SSB antibody was negative. Her hepatic transaminases were high. But no cardiac manifestations were noted.

Focal seizures as an unusual presentation of neonatal lupus erythematosus.

Neonatal lupus erythematosus is an uncommon passive autoimmune disease in which there is a transplacental passage of anti-Ro/SSA and/or anti-La/SSB maternal autoantibodies. Common clinical manifestations include cardiac disease, notably congenital heart block, cutaneous lupus lesions, hematologic disorders, and hepatobiliary disease. During the past decade, however, it has become clear that central nervous disease may also be a manifestation of neonatal lupus. We report a male neonate with the disease who had focal seizures in addition to cutaneous lupus, anemia, and thrombocytopenia. Brain ultrasound revealed normal ventricular size without a midline shift or intracranial or intraventricular hemorrhage. A brain CT showed generalized low density involving the periventricular and deep white matter. A sleep EEG revealed rare spikes axial to the right parietal lobe. The neonate had a high titer of antinuclear antibodies (1:640) with a speckled pattern, anti-Ro/SSA and anti-La/SSB antibodies, but no anti-dsDNA antibodies. He was given anti-convulsant drugs with dramatic improvement of his symptoms. One month later, a sleep EEG was normal, and he had no further seizures.

Anticuerpos a proteínas recombinantes Ro60 Kd, Ro52 Kd y La48 Kd, en el síndrome de Sjögren primario. Utilidad de la combinación de métodos analíticos para detectar anticuerpos anti Ro y anti La / Antibodies against recombinant Ro 60 Kd, Ro 52 and La 48 Kd proteins in primary Sjogren's Syndrome. Utility of analytic methods combination to detect antibodies anti Ro and La

BACKGROUND: The use of new recombinant antigens may increase the sensitivity and specificity of the detection of anti Ro and anti La antibodies in Sjögren's syndrome. AIM: To determine the immune reactivity of sera from patients with Sjögren's syndrome, against fusion recombinant proteins (prf) Ro60 Kd, Ro52 Kd and La48 Kd expressed in E coli and recombinant protein Ro52 Kd, expressed in baculovirus (prb). MATERIAL AND METHODS: Serum samples from 46 patients with a diagnosis of Sjögren's syndrome, according to the European criteria of 1997, were studied. Using conventional ELISA assays, 32 patients had positive anti Ro antibodies (group A) and 16 patients had negative anti Ro and anti La antibodies, but had positive antinuclear antibodies or rheumatoid factors (group B). Antibodies against recombinant proteins were measured by ELISA or Western Blot. RESULTS: Reactivity against prf Ro60 was present in 69 per cent of samples from group A patients and in 36 per cent of samples from group B. Reactivity against prf Ro52 was present in 94 per cent of samples from group A and 50 per cent of samples from group B. Reactivity against prb Ro52 was present in 75 per cent of samples from group A and 40 per cent of samples from group B. Reactivity against prf La was present in 78 per cent of samples by ELISA and 97 per cent of samples by Western Blot. In 10 of 14 serum samples from group B patients, there was reactivity against at least one recombinant protein. CONCLUSIONS: A high prevalence of reactivity against recombinant Ro and La proteins was detected in serum samples from patients with Sjögren syndrome.

Comparison of counter immunoelectrophoresis with immunoblotting for detection of anti-extractable nuclear antigen antibodies in systemic lupus erythematosus.

Anti-extractable nuclear antigen (ENA) antibodies were assayed by counter immunoelectrophoresis (CIE) and immunoblotting in patients with systemic lupus erythematosus (SLE). We found the two methods showed good concordance rates, the lowest being 67% for anti-SS-A. Immunoblotting was more sensitive in detecting anti-Sm, anti-SS-B and anti-PCNA (proliferating cell nuclear antigen); CIE was more sensitive for anti-nRNP and anti-SS-A. Overall, the prevalence of these anti-ENA antibodies in SLE was increased by 9-20% if immunoblotting was used in addition to CIE. Sera specific for the 52 kDa peptide of the SS-A antigen (anti-52kDa SS-A) were better detected by immunoblotting. Anti-PCNA antibody was found in 6.3% of SLE patients and was associated with active disease and hemolytic anemia. The positive rate of anti-Sm was 9% by CIE and 23.7% by immunoblotting and this antibody was a specific marker for SLE using either method. It was concluded that using immunoblotting in addition to CIE, the overall sensitivity of detection of anti-ENA antibodies in SLE was increased and clinically useful antibodies such as anti-52kDa SS-A and anti-PCNA could be detected.

Producción y análisis de proteínas recombinantes obtenidas de la cepa lisogénica Ro-531

La expresión del cDNA que codifica al antígeno Ro, fue evaluada usando la clona Ro=531 gt11 cuyos productos de traducción fueron inmunorreconocidos por un suero anti-Ro. La producción de proteína Ro recombinante, fue inducida en la cepa lisogénica E. coli Y1089. La antigenicidad de la proteína fue probada por Western blot y por ELISA. En la primera prueba, 15 de los 20 sueros anti-Ro positivos presentaron fuerte reactividad a la proteína de funsión Ro y 4 de los 20 sueros controles, mostraron reactividad débil. Por la técnica de ELISA, se observó una reacción más específica, ya que 15 de los 20 sueros anti-Ro positivos exhibieron afinidad por la proteína Ro recombinante y ninguno de los controles presentó falsos positivos

HLA-DR em portadores de lúpus eritematoso sistêmico com anticorpos anti-ribonucleoproteína e na doença mista do tecido conectivo / HLA-DR in patients with systemic lupus erythematosus with anti-ribonucleoprotein antibodies and in mixed connective tissue disease

Comparam-se os fenótipos HLA-DR subpopulaçäo (13 pacientes) de lúpus eritematoso sistêmico que evolui na presença de títulos levados de anticorpos anti-RNP com subpopulaçäo de DMTC (13 pacientes). Encontra-se a presença de antígeno DR4 em proporçäo estatisticamente significante na subpopulaçäo LES/anti-RNP enquanto que os pacientes de DMTC apresentam distribuiçäo dos antígenos DR semelhante à populaçäo normal. Conclui-se por subsídio preliminar a possível diferença genética de ambas as populaçöes