Latest news with #autoantibodies
Medscape
18-06-2025
- Health
- Medscape
Puffy Fingers or Hands Often Precede Raynaud in SSc
While Raynaud phenomenon is often the initial clinical manifestation of systemic sclerosis (SSc), over 30% of patients in two large US cohorts presented first with other manifestations — predominantly puffy fingers and hands. These patients exhibited more severe skin disease and increased joint contractures than those showing Raynaud as their initial symptom. METHODOLOGY: Researchers analyzed data from two large US cohorts to assess the clinical features of SSc in patients whose first manifestation was a non-Raynaud symptom. They included 1377 patients older than 18 years with SSc who were diagnosed within 5 years of their first non-Raynaud symptom and met standardized SSc classification criteria. Date on baseline demographics, clinical features (such as skin involvement, joint contractures, and tendon friction rubs), and the presence of specific autoantibodies were collected. Serologic testing was performed for antinuclear antibodies and SSc-specific autoantibodies using HEp-2 indirect immunofluorescence assay and other specific laboratory or clinical assays. TAKEAWAY: In both the cohorts, 31%-44% of patients had a non-Raynaud symptom — most commonly puffy fingers or hands — as their initial sign of SSc preceding the onset of Raynaud phenomenon. Black patients were more likely to present with non-Raynaud symptoms as their first manifestation than patients from other racial and ethnic backgrounds. Patients who initially presented with non-Raynaud symptoms had a significantly higher prevalence of diffuse cutaneous involvement, joint contractures, and tendon friction rubs at baseline. In both cohorts, RNA polymerase III antibody was significantly more prevalent in patients who presented with non-Raynaud phenomenon first than in those who presented with Raynaud phenomenon first ( P <.01 for both cohorts). IN PRACTICE: "Future research aimed at understanding and/or treating patients in the early stages of SSc should be inclusive of those presenting without [Raynaud phenomenon] if other risk features (eg, puffy fingers/hands, abnormal nailfold capillaries, skin tightening, tendon friction rubs, positivity for ANA and SSc-associated specific autoantibodies) are present," the authors wrote. SOURCE: This study was led by Iqtidar Hanif, MD, MS, UTHealth Houston Division of Rheumatology, Houston, Texas. It was published online on May 19, 2025, in Arthritis & Rheumatology . LIMITATIONS: The study relied on patient recall, which may have introduced bias and imprecision in reporting symptom onset. There was also a lack of standardization across sites in assessing the presence of Raynaud phenomenon. Additionally, the findings may be influenced by referral bias, as patients seen at academic medical centers are often referred by other rheumatologists or seek second opinions independently. DISCLOSURES: One of the cohorts was supported by the Scleroderma Research Foundation, and some authors reported receiving grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Some authors reported receiving financial support, grants, or consulting fees from various pharmaceutical companies.
Medscape
22-05-2025
- Health
- Medscape
Novel Autoantibodies Linked to Thrombosis Risk in Lupus
Anti–transcription factor A, mitochondrial (anti-TFAM) antibodies in patients with systemic lupus erythematosus (SLE) were associated with a threefold increased risk for thrombotic events. METHODOLOGY: Researchers discovered the autoantibody in an exploratory sample of 22 patients with SLE and nine healthy controls. The findings were validated using a sample of 158 patients with SLE and 98 healthy control individuals from the 'Study of biological Pathways, Disease Activity and Response markers in patients with Systemic Lupus Erythematosus' (SPARE) cohort. Researchers used comprehensive clinical, serological, and gene expression data collected from the SPARE cohort to identify clinical features associated with anti-TFAM antibodies. TAKEAWAY: Anti-TFAM antibodies were detected in 30.3% of patients with SLE (48 of 158) and 4% of healthy controls (four of 98). Patients with SLE who were positive for anti-TFAM antibodies showed significantly higher risk for thrombosis (odds ratio [OR], 2.9) and antiphospholipid syndrome (APS; OR, 5.4), independent of traditional APS-associated antibodies. The presence of both anti-TFAM antibodies and lupus anticoagulant demonstrated an additive effect, increasing thrombosis risk substantially (OR, 8.71). IN PRACTICE: 'Anti-TFAM antibodies are potential biomarkers for identifying SLE patients at risk of thrombosis, independent of traditional APS-associated antibodies. These novel autoantibodies may aid in disease evaluation and treatment strategies for SLE, as well as provide novel insights into disease mechanisms, particularly those related to thrombotic events and APS,' study authors wrote. SOURCE: The study was led by Eduardo Gómez-Bañuelos, MD, PhD, Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore. It was published online in Annals of the Rheumatic Diseases on May 10, 2025. LIMITATIONS: Due to the cross-sectional nature of the sample collection, the researchers could not determine whether anti-TFAM seroconversion occurs simultaneously or sequentially with vascular events in SLE. The significance of anti-TFAM antibodies with thrombotic events in other patient groups without SLE or primary APS requires further investigation. DISCLOSURES: The study was funded by the Jerome L. Greene Foundation, the National Institute of Allergy and Infectious Diseases, and the National Institute of Arthritis and Musculoskeletal and Skin Diseases. One author disclosed receiving consulting fees and/or royalties from Celgene, Inova, Advise Connect Inspire, and Hillstar Bio Inc.
