A clinical analysis of primary Sj(o)gren's syndrome with anticentromere antibodies / 中华内科杂志

ABSTRACT

Objective To investigate the clinical manifestations, immunological features and prognosis of primary Sj(o)gren's syndrome(pSS) with anticentromere antibodies(ACA). Methods Sixty pSS patients with ACA in our hospital between 1985 and 2006 were screened retrospectively and compared with those without ACA. Results The mean age at the onset of pSS with ACA was higher than that of those without ACA[(48±11)yr vs(41±12)yr,P=0.000].There was no difference in sex ratio,dry mouth.dry eyes and positive salivary gland biopsy between the two groups(P＞0.05).Compared with those without ACA,patients with ACA presented a higher prevalence of liver involvement(68.3%vs 37.0%,P=0.000),while a lower prevalence of renal involvement(13.3%vs 30.9%,P=0.009), neuropathy(1.7% vs 11.5%,P=0.025)and hypergammaglobulinemia(20.8%vs 45.7%,P=0.002). The difference was not significant between the two groups in Raynaud's phenomenon,articular involvement,myositis,hematologic involvement,lung involvement,and thyroiditis. While both groups showed the same prevalence of antinuclear antibody(ANA),the patterns of ANA-IF were different and the discrete speckled pattern was the most freqent in patients with ACA and occurred in 61.7%. Different from those without ACA,patients with ACA presented a lower prevalence of anti-SSA,anti-SSB, rheumatoid factor, and antiU1 RNP,while showed a higher prevalence of antimitochondrial antibodies(AMA) and AMA-M2. The most frequent cause of death was the complications associated with cirrhosis,notably bleeding varices(3/5 cases). Conclusion Patients with ACA present a high risk of liver involvement. Because of the remarkable difference in the mean age of disease onset and also differences in systemic damage, immunological and antibody features, pSS with ACA may be a special subtype of pSS.