ANA-negative systemic lupus erythematosus

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ANA-negative systemic lupus erythematosus

www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2230.1983.tb01795.x?cookieSet=1\

& journalCode=ced

Summary

A subset of patients who often satisfy the ARA criteria for SLE but whose

sera lack antinuclear antibodies when tested against various standard

substrates is reviewed.

Such a subset of patients forms a distinct clinical and serological group.

The majority of these patients present with cutaneous lesions frequently

seen in discoid or systemic lupus erythematosus. Involvement of other organ

systems is less frequent in this group compared to ANA-positive SLE. The

sera of these patients usually contain anti-Re and anti-La antibodies

detectable by double immunodiffusion.

While most patients deposit immunoglobulins in the lesional skin, direct

immunofluorescence of uninvolved skin is positive only in approximately ten

per cent of patients. The clinical course is marked by relapses and

remissions and is favourable compared to ANA-positive SLE patients.

Ten percent of SLE patients who are initially ANA-negative become

ANA-positive on follow-up of approximately 4 years. Topical therapy alone

may be helpful when only cutaneous manifestations are present. Systemic

steroids and antimalarials are the mainstay of therapy in most cases.

A. RAZZAQUE AHMED11Division of Dermatology, Department of Medicine, UCLA

School of Medicine, Los Angeles, CA 90024 U.S.A. AND

STEVEN WORKMAN11Division of Dermatology, Department of Medicine, UCLA School

of Medicine, Los Angeles, CA 90024 U.S.A.

1Division of Dermatology, Department of Medicine, UCLA School of Medicine,

Los Angeles, CA 90024 U.S.A.

A. Razzaque Ahmed, M.D., Division of Dermatology, UCLA School of Medicine,

CHS 52-121, Los Angeles, CA 90024, U.S.A.