Clinical Implications of the Presence of Anti-Ro Antibodies in Systemic Lupus Erythematosus in Sudan

Abstract

Background: Ro- antigen is among many antigens that can be detected in SLE patients, with anti-Ro antibodies amounting to 90% in some patients. Although anti-Ro antibodies can be detected earlier than other antibodies, still their role is to be determined.

Aim: To estimate the occurrence of anti-Ro antibodies in patients with SLE, and its relation to classification criteria of the American College of Rheumatology (ACR) in Sudan.

Materials and Methods: Eighty- six patients with SLE, recruited from two rheumatology clinics in Omdurman- Sudan during the period November 2012 - May 2014. Participants gave consent then were interviewed for socio- demographic information and examined for skin, cardio-pulmonary, renal, neurological, and hematological manifestations to fulfill the ACR criteria for classification SLE. A Blood sample for full blood count, renal function, inflammatory markers, and antinuclear antibody profile including anti-Ro (SSA) was taken. This study was approved by the ethical committees of Omdurman and Military Teaching Hospitals. The Statistical Package for Social Sciences (SPSS) version 19 was used for data analysis. The Chi- square test was used for the relationship between categorical variables, and then Pearson's correlation was applied for different variables.

Results: Mean age was 36.4±11.6years, ranged from 18- 65 years. Female dominance is obvious (94.2%). Sixty six (76.7%) of subjects had arthritis, 45(52.3%) had oral or nasal ulcers, 35(40.7%) had malar rash, 31(36%) had photosensitive rash, while discoid rash was reported in 17(19.8%). Twenty nine (33.7%) of SLE patients were positive for anti-Ro antibodies. The positive percentage was 100%, 50%, 45.8% and21.1% in patients with pericarditis, renal involvement, pleurisy and neuro-psychiatric manifestations respectively. While anti- Ro antibodies were detected in 35.9% of patients with positive anti- nuclear antibodies.

Conclusion: In the present study no association was found between anti-Ro antibody and the various manifestations of SLE. Larger multicenter studies are needed to assess the occurrence of anti-Ro antibodies in SLE, and their relationship with disease activity.

Keywords: Anti-Ro (SSA), SLE, ACR criteria