Complement and antibody primary immunodeficiency in juvenile systemic lupus erythematosus patients.

Abstract:

OBJECTIVE:To evaluate the frequency of primary immunodeficiencies (PID) in juvenile systemic lupus erythematosus (JSLE) patients. METHODS:Some 72 JSLE patients were analyzed for levels of immunoglobulin classes and IgG subclasses and early components of the classical complement pathway. Determination of C4 gene copy number (GCN) and detection of type I C2 deficiency (D) were also performed. RESULTS:PID was identified in 16 patients (22%): C2D in three, C4D in three, C1qD in two, IgG2D (<20 mg/dl) in four, IgAD (<7 mg/dl) in three, and IgMD (<35 mg/dl) in three; one of these patients presented IgA, C2 and C4D. Two patients had low C4 GCN and two had type I C2D. Demographic data, family history of autoimmune disease and PID, JSLE clinical findings, occurrence of infections, disease activity and therapies were similar in patients with and without PID (p > 0.05). Remarkably, the median of Systemic Lupus International Collaborating Clinics/ACR-damage index (SLICC/ACR-DI) was significantly higher in JSLE patients with PID compared with patients without these abnormalities (p = 0.0033), likewise the high frequency of SLICC/ACR-DI > 1 (p = 0.023). CONCLUSIONS:A high frequency of PID was observed in JSLE patients, suggesting that these defects may contribute to lupus development. Our findings indicate that these two groups of PID should be investigated in severe pediatric lupus.

journal_name

Lupus

journal_title

Lupus

authors

Jesus AA,Liphaus BL,Silva CA,Bando SY,Andrade LE,Coutinho A,Carneiro-Sampaio M

doi

10.1177/0961203311411598

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

1275-84

issue

12

eissn

0961-2033

issn

1477-0962

pii

0961203311411598

journal_volume

20

pub_type

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