Publication | Closed Access
DISCOID LUPUS ERYTHEMATOSUS<subtitle>A Study of the Clinical Features and Biochemical and Serological Abnormalities in 120 Patients with Observations on the Relationship of this Disease to Systemic Lupus Erythematosus</subtitle>
34
Citations
0
References
1966
Year
ImmunohematologyImmunodeficienciesImmunologyPathologyClinical FeaturesDermatologyInflammatory ArthritisHematologyImmunohaematologyAutoantibodiesClinical DiseaseHealth SciencesRheumatologyAutoimmune DiseaseSystemic Lupus ErythematosusSystemic Lupus Erythematosus TreatmentLupus NephritisRheumatic DiseasesAutoimmunityImmunologic DiseaseAntibody ScreeningDiscoid Lupus ErythematosusLupusAntinuclear Antibodiesγ GlobulinMedicine
Antinuclear antibodies were detected in the sera of 42 of 120 patients (35 per cent.) with discoid lupus erythematosus and in 11 of 120 matched controls (9 per cent.). The ‘homogeneous’ antinuclear antibody was the dominant antibody in 29 sera and the ‘speckled’ in 13 sera. In general, the antibody titres were lower than those found in systemic lupus erythematosus but the H: S ratios were similar in both varieties of the disease. There was no relationship between antinuclear antibodies and the sex of the patient or the presence of anaemia. The antinuclear antibodies were commoner in older patients and in those who had suffered from the disease for longer periods or had more extensive skin involvement. Antinuclear antibodies were commoner in patients who showed some other evidence of lowgrade systemic involvement, e.g. chilblains, Raynaud's phenomenon, joint pains, leucopenia, thrombocytopenia and raised E.S.R., or serum γ globulin. Although antinuclear antibodies were more frequent in patients with a positive Rose-Waaler test, the titres of the two were quite unrelated. Four of the patients had ringed erythema multiforme-like lesions and the serum contained ‘speckled’ antinuclear antibody, anti-SjT precipitin, and rheumatoid factor in each case. It was considered that this represents a true syndrome rather than a spurious association of two unrelated diseases. There was no indication that the prognosis in these patients is materially different from that of uncomplicated discoid lupus erythematosus. Some manifestation of systemic abnormality was found in 55 per cent. of patients in the present series but it has been deduced that the risk of patients with discoid lupus erythematosus developing overt systemic lupus erythematosus is less than 5 per cent. it is suggested that the infrequent transformation of discoid lupus erythematosus into the systemic disease can be explained by the genetic differences between the two groups of patients.