Autoantibodies coexistence in systemic sclerosis: how to interpret it?

Area of Science:

• Rheumatology
• Immunology
• Clinical Medicine

Background:

• Systemic sclerosis (SSc) is characterized by autoantibodies, historically thought to be mutually exclusive.
• The coexistence of multiple autoantibodies in SSc challenges this paradigm, raising questions about disease heterogeneity.

Observation:

• Autoantibody prevalence is high in early SSc, but the concomitance of anti-centromere antibody (ACA) and antitopoisomerase 1 antibody (ATA) is rare.
• The simultaneous presence of ACA, ATA, and anti-RNA polymerase III (anti-RNA-P III) in a single patient has not been previously documented.

Findings:

• This report details the first case of a patient with SSc positive for ACA, ATA, and anti-RNA-P III.
• The patient exhibited early vascular manifestations and later developed limited cutaneous involvement.

Implications:

• The coexistence of multiple autoantibodies may represent a rare serological subgroup within SSc.
• This finding could have significant clinical and prognostic value, warranting further investigation into distinct SSc patient subgroups.