[Specific antibodies of soluble nuclear antigens in autoimmune vasculitis]

In order to assess the clinical value of antinuclear antibody (ANA) assays in classifying vasculitis, 136 sera from 28 patients with cutaneous vasculitis alone, and 80 patients with vasculitis associated with a connective tissue disease or an unclassified arthritis were tested. ANAs were assayed by indirect immunofluorescence, anti-ENA and anti-histone antibodies were tested by immunodiffusion. ANAs are seldom in patients with cutaneous vasculitis alone (1 positive serum/28 = 3.5%). ANAs are more generally observed in vasculitis associated with systemic lupus erythematosus (SLE) (15 positive sera/16 vasculitis associated with SLE = 94%), rheumatoid arthritis (RA) (8 positive/30 RA with vasculitis = 27%), or a Sjögren syndrome (SS) (9 positive/19 vasculitis with SS = 47%). ANAs in SS are correlated with vasculitis or Raynaud's phenomenon. ANAs are not detected in vasculitis associated with other connective tissue diseases or unclassified arthritis. Anti-ENA antibodies are only found in vasculitis associated with SLE (11 positive sera/13 = 85%) or SS (3 positive sera/19 = 16%). Contrasting with the findings of other groups, our results show no anti-ENA antibodies in RA with vasculitis. Anti-RNP in SLE are correlated with cutaneous vasculitis (p less than 0.005). An antibody different from anti-Ro (SS-A) antibodies but precipitating with a trypsinized human spleen extract was observed in 2/11 sera from RA with vasculitis and not in other sera. Its significance is not established yet; this antibody would have a clinical interest only if further studies showed a high prevalence in rheumatoid vasculitis.