Document Detail

Anti-U3 RNP autoantibodies in systemic sclerosis.
MedLine Citation:
PMID:  19333934     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe the classification, demographic and clinical features, and survival in anti-U3 RNP autoantibody-positive patients with systemic sclerosis (SSc). METHODS: Medical records of 108 anti-U3 RNP-positive and 2,471 anti-U3 RNP-negative SSc patients first evaluated during 1985-2003 were reviewed. Anti-U3 RNP antibody was detected by protein and RNA immunoprecipitation. Disease classification, demographic and clinical features, organ system involvement, and survival were compared between the 2 patient groups, by Student's t-test, chi-square analysis, and Mantel-Haenszel test. RESULTS: The anti-U3 RNP-positive group had a higher proportion of African American patients (27% versus 5%; P < 0.001) and male patients (29% versus 19%; P = 0.021), and was younger at the time of first physician diagnosis (mean age 42.8 years versus 47.4 years; P = 0.001). The 2 groups had similar proportions of patients with diffuse cutaneous involvement (47% and 45% in those with and those without anti-U3 RNP, respectively). However, among patients with diffuse cutaneous involvement, the mean maximum modified Rodnan skin score was significantly lower in the anti-U3 RNP group (22.3 versus 27.9; P < 0.001). Skeletal muscle involvement was more frequent in anti-U3 RNP-positive patients (25% versus 14%; P = 0.002), as was "intrinsic" pulmonary arterial hypertension (PAH) (31% versus 13%; P < 0.001). The frequency of gastrointestinal involvement, cardiac involvement, pulmonary fibrosis, and "renal crisis" did not differ significantly between the 2 groups. Survival was worse in the anti-U3 RNP-positive group (hazard ratio 1.38 [95% confidence interval 1.05-1.82]). PAH was the most common known cause of death in patients with anti-U3 RNP (30%, versus 10% in the anti-U3 RNP-negative group; P < 0.001). CONCLUSION: The present findings demonstrate that the frequencies of African American race and male sex are greater among SSc patients with anti-U3 RNP antibody than those without, and the former group is younger at SSc diagnosis. Anti-U3 RNP-positive patients have more frequent skeletal muscle involvement and PAH, the latter being the most common cause of death.
Rohit Aggarwal; Mary Lucas; Noreen Fertig; Chester V Oddis; Thomas A Medsger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  60     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-07     Completed Date:  2009-06-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1112-8     Citation Subset:  AIM; IM    
University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
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MeSH Terms
African Americans / statistics & numerical data*
Autoantibodies / blood*
European Continental Ancestry Group / statistics & numerical data*
Gastrointestinal Diseases / ethnology,  immunology,  mortality
Heart Diseases / ethnology,  immunology,  mortality
Hypertension, Pulmonary / ethnology,  immunology,  mortality
Middle Aged
Pulmonary Fibrosis / ethnology,  immunology,  mortality
Ribonucleoproteins, Small Nucleolar / immunology*
Scleroderma, Systemic / ethnology*,  immunology*,  mortality
Seroepidemiologic Studies
Sex Distribution
Skin Diseases / ethnology,  immunology,  mortality
Survival Analysis
Reg. No./Substance:
0/Autoantibodies; 0/Ribonucleoproteins, Small Nucleolar; 0/ribonucleoprotein, U3 small nucleolar

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