Fedrigo A, Dos Santos T A F G, Nisihara R, Skare T
1 Rheumatology Service, Evangelical University Hospital of Curitiba, Curitiba, Brazil.
2 Department of Medicine, Positivo University, Curitiba, Brazil.
Lupus. 2018 Jul;27(8):1368-1373. doi: 10.1177/0961203318759607. Epub 2018 Feb 20.
Background Patients with systemic lupus erythematosus (SLE) may form clusters with clinical manifestations and autoantibodies. Objective The objective of this report is to study whether SLE patients with positive rheumatoid factor (RF) have a special clinical and/or serological profile. Methods A retrospective study of 467 SLE patients seen at a single rheumatology unit was conducted. Epidemiological data (age, gender, age at disease onset, ethnic background and tobacco use), clinical data (malar rash, photosensitivity, oral ulcers, discoid lesions, serositis, glomerulonephritis, convulsions, psychosis, hemolytic anemia, leukopenia, lymphocytopenia, arthritis and hypothyroidism) and serological profile (anti-dsDNA, anti-Ro/SS-A, anti-La/SS-B, anti-RNP, anti-Sm, IgG aCL, IgM aCL, lupus anticoagulant, direct Coombs and RF) were collected. Patients with positive and negative RF were compared. Results RF was found in 24.9% of the sample. In univariate analysis, RF was positively associated with butterfly rash ( p = 0.04), anti-Ro ( p = 0.03), anti-Sm antibodies ( p = 0.01) and hypothyroidism ( p = 0.01) and negatively associated with glomerulonephritis ( p = 0.003). Logistic regression showed that only glomerulonephritis ( p = 0.03; OR = 0.45; 95% CI = 0.21-0.93) and anti-Ro ( p = 0.009; OR = 2.3; 95% CI = 1.24-4.57) were independent associations. Conclusion In our sample RF was associated with protection from glomerulonephritis and with higher prevalence of anti-Ro antibodies.
系统性红斑狼疮（SLE）患者可能会出现具有临床表现和自身抗体的聚集现象。目的：本报告旨在研究类风湿因子（RF）阳性的SLE患者是否具有特殊的临床和/或血清学特征。方法：对在单一风湿病科就诊的467例SLE患者进行回顾性研究。收集流行病学数据（年龄、性别、发病年龄、种族背景和吸烟情况）、临床数据（颧部红斑、光过敏、口腔溃疡、盘状红斑、浆膜炎、肾小球肾炎、惊厥、精神病、溶血性贫血、白细胞减少、淋巴细胞减少、关节炎和甲状腺功能减退）以及血清学特征（抗双链DNA、抗Ro/SS - A、抗La/SS - B、抗RNP、抗Sm、IgG抗心磷脂抗体、IgM抗心磷脂抗体、狼疮抗凝物、直接抗人球蛋白试验和RF）。比较RF阳性和阴性的患者。结果：样本中24.9%的患者RF呈阳性。单因素分析显示，RF与蝶形红斑（p = 0.04）、抗Ro（p = 0.03）、抗Sm抗体（p = 0.01）和甲状腺功能减退（p = 0.01）呈正相关，与肾小球肾炎呈负相关（p = 0.003）。逻辑回归显示，只有肾小球肾炎（p = 0.03；OR = 0.45；95%CI = 0.21 - 0.93）和抗Ro（p = 0.009；OR = 2.3；95%CI = 1.24 - 4.57）为独立关联。结论：在我们的样本中，RF与预防肾小球肾炎以及抗Ro抗体的较高患病率相关。
