373 CLINICAL ASSOCIATIONS WITH SS-A ANTIBODIES IN CHILDREN

Abstract

Antibodies to SS-A (Ro) are associated with primary Sjögren's syndrome, Systemic Lupus Erythematosus (SLE), subacute cutaneous LE with of without C2 deficiency and neonatal lupus. They can also be found in up to 1 % of healthy individuals. Antibodies to SS-A are rare in childhood.

We retrospectively looked at clinical pictures of all children who had circulating SS-A antibodies determined with immunodiffusion (IF) and ELISA techniques in the year 1993. SS-A antibodies were detected in nine children, six girls and three boys. The majority of children were from Caucasian origin, two were Hindustan and one negroid. One of the patients was a neonate with a congenital heart-block (mother ANA and SS-A positive without clinical symptoms). In the other children the age of onset of clinical symtoms varied from 5 to 12 years. Two patients were diagnosed as SLE with secondary Sjögren's syndrome, two as SLE with nefritis (one with restrictive lung disease), three as undefined autoimmune disease (one with a chronic uveitis) and two boys with fatigue, myopathy and parotic swellling (Raynaud's phenomenon in one). In all patients fatigue was a predominant symptom. None of the patients complained of dry eyes. Antinuclear antibodies were positive in seven children, antibodies to dsDNA in four. In conclusion, SS-A antibodies are associated with a limited number of clinical syndromes and may be present in spite of a negative ANA-IF test. Longtime follow-up is indicated as it may take years for autoimmune diseases to fully develop.

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