[Comparison of severity and native anti-DNA antibody levels in systemic lupus erythematosus. Serodiscordant lupus].

The authors studied the clinicobiological correlations between the severity of systemic lupus erythematosus (SLE) and native anti-DNA antibody levels in 176 patients suffering from this disease. Certain patients were studied at different stages of their disease. This correlation was very close in one out of two cases and relative in one case out of four. In one-fourth of these patients, a significant and persistent discordance existed, and these patients were therefore studied apart. Certain SLE which have been suppressed over long periods of time continue to have elevated anti-DNA levels which are occasionally associated with lowered levels of complement. This has been previously reported in the literature. All decisions to modify corticosteroid treatment based only on biological data is therefore questionable. In contrast, in certain cases of SLE where the evolution of the disease is relatively severe, no anti-DNA or antinuclear antibodies are present. These "seronegative" SLE cases are proof that the "specific" biology of this disease may be erroneous for diagnosis as well as for prognosis. The authors review the possible or known causes for the absence of these antibodies in SLE. They believe that native anti-DNA levels are only of relative value in SLE and feel that these values must be examined with respect to clinical and other biological data in order to treat and survey patients affected with this disease.