Sener Seher, Batu Ezgi Deniz, Unal Dilara, Basaran Ozge, Saribas Zeynep, Bilginer Yelda, Sener Burcin, Ozen Seza
Division of Pediatric Rheumatology, Department of Pediatrics, Hacettepe University, Ankara, Turkey.
Department of Medical Microbiology, Hacettepe University, Ankara, Turkey.
Lupus. 2025 Jan;34(1):71-78. doi: 10.1177/09612033241305198. Epub 2024 Nov 27.
Antinuclear antibodies (ANA) staining patterns can provide useful information in systemic lupus erythematosus (SLE). In our study, we examined the frequency of ANA staining patterns in disease-related features in childhood-onset SLE patients.
ANA and its staining patterns were assessed in childhood-onset SLE patients.
Two hundred twenty-three patients were included (F/M = 3/1). Their median age at diagnosis was 14.3 (11.9-16.1) years. The anti-cell (AC)-4/5 (fine or large speckled) pattern was the most common nuclear ANA pattern (75.8%), while the AC-19 (dense fine speckled) pattern was the most frequently detected cytoplasmic ANA pattern (13.1%). The AC-4/5 (fine or large speckled) patterns were notably seen in fever, acute and chronic cutaneous lupus, arthritis, serositis, hematologic involvement, renal involvement, neuropsychiatric involvement, gastrointestinal involvement, and cardiopulmonary involvement (all < .001). Conversely, the AC-1 (homogeneous) pattern was significantly detected in oral/nasal ulcers and non-scarring alopecia (both < .001). Regarding the laboratory features, the AC-4/5 (fine or large speckled) patterns exhibited a predominant seen in autoimmune hemolytic anemia, leukopenia, thrombocytopenia, elevated ESR and CRP, hypocomplementemia, direct Coombs, anti-Smith (Sm), anti-SSA and SS-B, anti-ribonucleoprotein (RNP), anti-histone, anti-ribosomal P, lupus anticoagulant, anti-cardiolipin immunoglobulin (Ig)M/IgG, and anti-β2-glycoprotein IgM/IgG positivities (all < .001). In contrast, the AC-1 (homogeneous) pattern was detected in anti-double-stranded (ds) DNA and anti-histone positivity (both < .001).
Our study showed that AC-4/5 and AC-1 patterns of ANA are frequently detected in many clinical and serological features of childhood-onset SLE patients. However, further studies are needed in larger populations to verify these results.
抗核抗体（ANA）染色模式可为系统性红斑狼疮（SLE）提供有用信息。在我们的研究中，我们调查了儿童期起病的SLE患者疾病相关特征中ANA染色模式的频率。
对儿童期起病的SLE患者进行ANA及其染色模式评估。
纳入223例患者（女性/男性 = 3/1）。他们诊断时的中位年龄为14.3（11.9 - 16.1）岁。抗细胞（AC）-4/5（细颗粒或大颗粒斑点状）模式是最常见的核ANA模式（75.8%），而AC-19（密集细颗粒状）模式是最常检测到的胞质ANA模式（13.1%）。AC-4/5（细颗粒或大颗粒斑点状）模式在发热、急性和慢性皮肤狼疮、关节炎、浆膜炎、血液系统受累、肾脏受累、神经精神系统受累、胃肠道受累及心肺受累中均显著可见（均P <.001）。相反，AC-1（均质型）模式在口腔/鼻腔溃疡和非瘢痕性脱发中显著检出（均P <.001）。关于实验室特征，AC-4/5（细颗粒或大颗粒斑点状）模式在自身免疫性溶血性贫血、白细胞减少、血小板减少、血沉和C反应蛋白升高、补体降低、直接抗人球蛋白试验、抗史密斯（Sm）、抗干燥综合征A（SSA）和B（SS-B）、抗核糖核蛋白（RNP）、抗组蛋白、抗核糖体P、狼疮抗凝物、抗心磷脂免疫球蛋白（Ig）M/IgG及抗β2糖蛋白IgM/IgG阳性中均占主导（均P <.001）。相比之下，AC-1（均质型）模式在抗双链（ds）DNA和抗组蛋白阳性中被检测到（均P <.001）。
我们的研究表明，ANA的AC-4/5和AC-1模式在儿童期起病的SLE患者的许多临床和血清学特征中经常被检测到。然而，需要在更大规模人群中进行进一步研究以验证这些结果。
