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Hypocomplementemia in systemic sclerosis--clinical and serological correlations.

Marie Hudson1, Jennifer G Walker, Marvin Fritzler

  • 1SMBD-Jewish General Hospital and McGill University, 3755 Cote Sainte-Catherine Road, Montreal, Quebec, Canada. marie.hudson@mcgill.ca

The Journal of Rheumatology
|October 17, 2007
PubMed
Summary

Low complement levels in systemic sclerosis (SSc) patients may signal overlap disease, specifically inflammatory myositis and vasculitis. This finding helps identify a distinct SSc subgroup.

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Area of Science:

  • Rheumatology
  • Immunology
  • Systemic Sclerosis Research

Background:

  • Hypocomplementemia, or low complement levels, is observed in systemic sclerosis (SSc) but not typically linked to its pathogenesis.
  • The association of hypocomplementemia with SSc suggests a potential role in disease subsets or related conditions.

Purpose of the Study:

  • To investigate whether hypocomplementemia in SSc patients is associated with an increased prevalence of overlap disease features.
  • To compare the rates of concomitant rheumatic conditions and autoantibody profiles between SSc patients with normal and low complement levels.

Main Methods:

  • Analysis of 321 patients from the Canadian Scleroderma Research Group Registry, categorized by normal (C3 and C4) or hypocomplementemia (low C3 or C4).
  • Overlap disease was defined by physician reports of other rheumatic conditions.
  • Comparison of disease frequencies and autoantibody profiles between the two complement groups.

Main Results:

  • Of 321 SSc patients, 14% exhibited hypocomplementemia.
  • Patients with hypocomplementemia showed significantly higher rates of physician-reported inflammatory myositis (27% vs. 12%) and vasculitis (11% vs. 2%) compared to those with normal complement levels.
  • A trend towards increased antichromatin antibodies was observed in the hypocomplementemia group (18% vs. 9%).

Conclusions:

  • Hypocomplementemia may serve as a clinical marker for identifying a specific subgroup of systemic sclerosis patients.
  • This subgroup is characterized by a higher likelihood of having overlap disease, including inflammatory myositis and vasculitis.