A young lady with ANA negative SLE and Secondary Antip Phospholipid Syndrome

A B S T R A C TSystemic lupus erythematosus (SLE) is a chronic, inflammatory,autoimmune, multisystem connective multi system connective tissuedisease characterized by various autoantibodies to nuclear and cytoplasmicantigens and commonly affects the joints and a variety of organs due to anover activation of the body's immune system. There is wide heterogeneity inpresentation of SLE patients, including lung, central nervous system, skin,kidney, and hematologic manifestations. The presence of antinuclearantibodies (ANA) in serum is generally considered a decisive diagnostic signof SLE. However, a small subset of SLE patients who had the typical clinicalfeatures of SLE was reported to show persistently negative ANA tests. Ourreport describes a 24-yr-old female who presented with the clinicalmanifestations of SLE such as malar rash, photosensitivity, arthritis, oralulcer, and proteinuria. The serum autoantibodies were all negative exceptanti ribosomal P. She was also positive for lupus anticoagulantanti -coagulant. She was treated with oral prednisolone , hydroxychloroquinewith topical tacrolimus, and improved significantly. Three months after,repeat ANA, and anti-ds DNA showed persistent negativity, but lupus anti -coagulant remained positive. This case suggests that ANA may not berequired in the pathogenesis of SLE.

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The clinical relevance of antibodies to ribosomal-P common epitope in two targeted systemic lupus erythematosus populations: a large cohort of consecutive patients and patients with active central nervous system disease

Annals of the Rheumatic Diseases ◽

10.1136/ard.59.2.99 ◽

2000 ◽

Vol 59 (2) ◽

pp. 99-104 ◽

Cited By ~ 71

Author(s):

A G Tzioufas

Keyword(s):

Systemic Lupus Erythematosus ◽

Central Nervous System ◽

Nervous System ◽

Lupus Erythematosus ◽

Clinical Relevance ◽

Central Nervous System Disease ◽

Nervous System Disease ◽

Systemic Lupus ◽

System Disease ◽

Ribosomal P

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Differential roles of the anti-ribosomal P antibody and antineuronal antibody in the pathogenesis of central nervous system involvement in systemic lupus erythematosus

Arthritis & Rheumatism ◽

10.1002/1529-0131(199810)41:10<1819::aid-art14>3.0.co;2-y ◽

1998 ◽

Vol 41 (10) ◽

pp. 1819-1827 ◽

Cited By ~ 95

Author(s):

Kunio Isshi ◽

Shunsei Hirohata

Keyword(s):

Systemic Lupus Erythematosus ◽

Central Nervous System ◽

Nervous System ◽

Lupus Erythematosus ◽

Central Nervous System Involvement ◽

Systemic Lupus ◽

System Involvement ◽

Antineuronal Antibody ◽

Ribosomal P

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Autoantibodies in Neuropsychiatric Systemic Lupus Erythematosus (NPSLE): Can They Be Used as Biomarkers for the Differential Diagnosis of This Disease?

Clinical Reviews in Allergy & Immunology ◽

10.1007/s12016-021-08865-2 ◽

2021 ◽

Author(s):

Elias Manca

Keyword(s):

Systemic Lupus Erythematosus ◽

Central Nervous System ◽

Nervous System ◽

Differential Diagnosis ◽

Human Body ◽

Lupus Erythematosus ◽

Neuropsychiatric Symptoms ◽

Systemic Lupus ◽

Neuropsychiatric Systemic Lupus Erythematosus ◽

The Central Nervous System

AbstractSystemic lupus erythematosus is a complex immunological disease where both environmental factors and genetic predisposition lead to the dysregulation of important immune mechanisms. Eventually, the combination of these factors leads to the production of self-reactive antibodies that can target any organ or tissue of the human body. Autoantibodies can form immune complexes responsible for both the organ damage and the most severe complications. Involvement of the central nervous system defines a subcategory of the disease, generally known with the denomination of neuropsychiatric systemic lupus erythematosus. Neuropsychiatric symptoms can range from relatively mild manifestations, such as headache, to more severe complications, such as psychosis. The evaluation of the presence of the autoantibodies in the serum of these patients is the most helpful diagnostic tool for the assessment of the disease. The scientific progresses achieved in the last decades helped researchers and physicians to discover some of autoepitopes targeted by the autoantibodies, although the majority of them have not been identified yet. Additionally, the central nervous system is full of epitopes that cannot be found elsewhere in the human body, for this reason, autoantibodies that selectively target these epitopes might be used for the differential diagnosis between patients with and without the neuropsychiatric symptoms. In this review, the most relevant data is reported with regard to mechanisms implicated in the production of autoantibodies and the most important autoantibodies found among patients with systemic lupus erythematosus with and without the neuropsychiatric manifestations.

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