{
  "abstract": "Objectives Autoantibodies serve as key diagnostic and classification criteria for systemic lupus erythematosus(SLE). In addition to serving as markers of disease, some autoantibodies can have a direct role in the clinical manifestations of SLE.Methods This observational retrospective-prospective study included 140 patients (88% women, median aged 34[26;41]years (median [interquartile range 25;75%]), with SLE(SLICC 2012) attending a routine visit at our Clinic. Baseline demographics, disease characteristic, organ system involvement/damage were analysed descriptively according to SLEDAI-2k, SDI.Results The median disease duration was 3,4 [0,4;12,0]years, SLEDAI-2k at the time of inclusion– 6,5 [4,0;10,5]score, SDI– 0 [0;2]score.Patients with SLE and positive anti-dsDNA at study inclusion were more likely to have arthritis/arthralgia, lupus nephritis(LN), hematological disorders due to leukopenia/lymphopenia and hemolytic anemia, had higher SLEDAI-2k and class III/IV LN activity index according to kidney biopsy, and no disease remission(SLEDAI-2k=0). Anti-dsDNA positivity was associated with a younger age at diagnosis, including juvenile onset, and with other immunological markers of SLEactivity: hypocomplementemia and elevated anti-C1q levels.Patients with SLE and elevated anti-Sm levels were more likely to have discoid cutaneous lupus erythematosus, oral and nasal ulcers, non-scarring alopecia, arthritis/arthralgia, thrombocytopenia, hemolytic anemia, fever and Raynaud’s phenomenon, higher SLEDAI-2k. Anti-Sm positivity was associated with anti-C1q and anti-RNP-70.Positive aPL in patients with SLE were more common not only in the presence of concomitant APS, but also in hematological manifestations(hemolytic anemia during the disease and thrombocytopenia at the time of the study), and were associated with hypocomplementemia and a shorter duration of SLE.Hypocomplementemia is associated with hematological abnormalities only, including leukopenia/lymphopenia and hemolytic anemia, immunological abnormalities(positive anti-dsDNA, aPL and anti-C1q), elevated SLEDAI-2k index, no disease remission and lower body weighConclusions The clinical heterogeneity of SLE may be based on antibody heterogeneity. The SLEDAI-2k activity index is associated not only with positive anti-dsDNA and hypocomplementemia, which are included in this score, but also with anti-Sm. Positive anti-dsDNA, anti-Sm and hypocomplementemia had similar associations with some clinical features: arthritis/arthralgia, LN, hematological disorders. Discoid lupus, non-scarring alopecia, mucosal lesions, fever, and Raynaud’s phenomenon are associated with anti-Sm positivity only, leukopenia/lymphopenia – with anti-dsDNA and hypocomplementemia, thrombocytopenia–with anti-Sm and aPL.",
  "authors": [
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Tatiana Panafidina"
    },
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Tatiana Popkova"
    },
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Anastasiia Shumilova"
    },
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Yulia Gorbunova"
    },
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Liubov Kondrateva"
    },
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Anastasia Avdeeva"
    },
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Moscow, Russia"
      ],
      "name": "Alexander Lila"
    }
  ],
  "title": "PO:02:040 The association between antibodies, complement C3/C4 and clinical features in patients with systemic lupus erythematosus: criterial markers",
  "uid": "801ad37c-ce65-51fb-98a9-521e084a2cec"
}