Anticuerpos antinucleares específicos y afectaciones orgánicas en 180 pacientes con lupus eritematoso sistémico

Elena Kokuina, Miguel Estévez del Toro, Ángela Gutiérrez, Alfredo Ortiz, Yeniset Sánchez, Dionisio Pérez Campos

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Resumen

Objetivo: el estudio está dirigido a determinar la presencia de varias especificidades antinucleares y su asociación con las afectaciones orgánicas en pacientes con  lupus eritematoso sistémico.
Métodos: se obtuvieron los datos clínicos presentes en los 12 meses anteriores de 180 pacientes consecutivos con diagnóstico de lupus eritematoso sistémico. Se determinaron los anticuerpos anti-ADN de doble cadena (dc), anti-nucleosoma (Nuc), anti-Sm, anti-RNP, anti-Ro, anti-La y anti-Topo 1 por ELISA. Las asociaciones con las afectaciones orgánicas fueron evaluadas por las pruebas de chi-cuadrado y Fisher.
Resultados: los anticuerpos de mayor prevalencia en los pacientes con lupus eritematoso sistémico fueron los anti-Nuc (75.0 %). Las asociaciones más fuertes resultaron las de los anti-Nuc con la afectación neurológica (p < 0.001) y articular (p < 0.001); de los anti-ADNdc con citopenias (p < 0.001); y de los anti-Sm y anti-RNP con la afectación neurológica (p < 0.001). La asociación más significativa con la nefritis lúpica fue la del C4 sérico bajo (p < 0.001). Las citopenias fue la afectación clínica asociada a la presencia de mayor variedad de anticuerpos (anti-Nuc, anti-ADNdc, anti-Sm, anti-RNP y anti-Topo 1), mientras que la afectación mucocutánea no se asoció a ningún marcador serológico.
Conclusión: los anticuerpos anti-Nuc, anti-ADNdc, anti-Sm y anti-RNP mostraron fuertes asociaciones con distintas afectaciones clínicas del lupus eritematoso sistémico. Estos datos proporcionan información clínica de utilidad para el seguimiento de los pacientes cubanos con lupus eritematoso sistémico.

Palabras clave

autoanticuerpos; afectación clínica; cubanos;lupus eritematoso sistémico

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