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. 2004 Jan;63(1):50–53. doi: 10.1136/ard.2002.001594

Long term prognosis of children born to lupus patients

A Murashima 1, T Fukazawa 1, M Hirashima 1, Y Takasaki 1, M Oonishi 1, S Niijima 1, Y Yamashiro 1, A Yamataka 1, T Miyano 1, H Hashimoto 1
PMCID: PMC1754725  PMID: 14672891

Abstract

Objective: To determine the long term prognosis of children of patients with systemic lupus erythematosus (SLE).

Methods: Children of patients with SLE were invited to attend our clinic for physical examination and laboratory tests. A total of 195 children (aged 4 months to 26 years; male = 82, female = 113) were examined in 1991, 1995, 1997, and 1998.

Results: Two cases were diagnosed as SLE at the first visit and were excluded from the second visit. A significantly higher percentage (52/195 (27%)) of patients were positive for antinuclear antibodies (ANA) at a cut off serum dilution of 1/40 compared with controls (4/57 (7%)). ANA were detected more frequently in female subjects than in men (p<0.05). Forty four subjects were examined on more than two occasions. Nine of the 10 patients who were positive for ANA at the second visit were girls aged 4–8 years. The incidence of anti-DNA and antiphospholipid antibodies in children of patients with SLE was similar to that in the controls.

Conclusions: The finding that children, especially girls, born to maternal lupus patients had a high positive rate for ANA suggests that a genetic factor is involved in SLE pathogenesis. Longitudinal observation of these patients may provide important clinical information and clues to the pathogenesis of SLE.

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Figure 1 .

Figure 1

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Presence of ANA in children born to lupus patients (n = 195). Except for two children younger than 6 months of age, all of the children with ANA were older than 3 years. Many cases were positive at a higher dilution. *Patient with SLE.

Figure 2 .

Figure 2

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The change of ANA levels in the children who attended more than twice (excluding children who were ANA positive or ANA negative at all investigations). One infant younger than 6 months of age was ANA positive at the first investigation, but had become negative at the second (1). Nine children (one male, eight female) had become positive for ANA at the time of the second investigation when they were 4–8 years of age (2–10). Three of them (one boy (9), two girls (8, 10)) had become negative again by the time of the third investigation. One girl became positive at 14 years old (12). One boy was positive at 5 years of age and had become negative by 11 years of age (11).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arroyave C. M., Giambrone M. J., Rich K. C., Walaszek M. The frequency of antinuclear antibody (ANA) in children by use of mouse kidney (MK) and human epithelial cells (HEp-2) as substrates. J Allergy Clin Immunol. 1988 Nov;82(5 Pt 1):741–744. doi: 10.1016/0091-6749(88)90073-5. [DOI] [PubMed] [Google Scholar]
  2. Artlett C. M., Miller F. W., Rider L. G., Childhood Myositis Heterogeneity Collaborative Study Group Persistent maternally derived peripheral microchimerism is associated with the juvenile idiopathic inflammatory myopathies. Rheumatology (Oxford) 2001 Nov;40(11):1279–1284. doi: 10.1093/rheumatology/40.11.1279. [DOI] [PubMed] [Google Scholar]
  3. Buckman K. J., Moore S. K., Ebbin A. J., Cox M. B., Dubois E. L. Familial systemic lupus erythematosus. Arch Intern Med. 1978 Nov;138(11):1674–1676. [PubMed] [Google Scholar]
  4. Lawrence J. S., Martins C. L., Drake G. L. A family survey of lupus erythematosus. 1. Heritability. J Rheumatol. 1987 Oct;14(5):913–921. [PubMed] [Google Scholar]
  5. Leonhardt E. T. Family studies in systemic lupus erythematosus. Clin Exp Immunol. 1967 Dec;2(Suppl):743–759. [PMC free article] [PubMed] [Google Scholar]
  6. Nelson J. L. Microchimerism and human autoimmune diseases. Lupus. 2002;11(10):651–654. doi: 10.1191/0961203302lu271oa. [DOI] [PubMed] [Google Scholar]
  7. Osborn T. G., Patel N. J., Moore T. I., Zuckner J. Use of the HEp-2 cell substrate in the detection of antinuclear antibodies in juvenile rheumatoid arthritis. Arthritis Rheum. 1984 Nov;27(11):1286–1289. doi: 10.1002/art.1780271111. [DOI] [PubMed] [Google Scholar]
  8. Sasai K., Furukawa S., Hashimoto H., Yabuta K. Increased levels of serum IgE in children of mothers with systemic lupus erythematosus. Allergy. 1995 Apr;50(4):370–373. doi: 10.1111/j.1398-9995.1995.tb01163.x. [DOI] [PubMed] [Google Scholar]
  9. Stewart J. J. The female X-inactivation mosaic in systemic lupus erythematosus. Immunol Today. 1998 Aug;19(8):352–357. doi: 10.1016/s0167-5699(98)01298-5. [DOI] [PubMed] [Google Scholar]
  10. Takasaki Y., Fishwild D., Tan E. M. Characterization of proliferating cell nuclear antigen recognized by autoantibodies in lupus sera. J Exp Med. 1984 Apr 1;159(4):981–992. doi: 10.1084/jem.159.4.981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Takei S., Maeno N., Shigemori M., Imanaka H., Mori H., Nerome Y., Kanekura S., Takezaki T., Hokonohara M., Miyata K. Clinical features of Japanese children and adolescents with systemic lupus erythematosus: results of 1980-1994 survey. Acta Paediatr Jpn. 1997 Apr;39(2):250–256. doi: 10.1111/j.1442-200x.1997.tb03594.x. [DOI] [PubMed] [Google Scholar]
  12. Tan E. M., Feltkamp T. E., Smolen J. S., Butcher B., Dawkins R., Fritzler M. J., Gordon T., Hardin J. A., Kalden J. R., Lahita R. G. Range of antinuclear antibodies in "healthy" individuals. Arthritis Rheum. 1997 Sep;40(9):1601–1611. doi: 10.1002/art.1780400909. [DOI] [PubMed] [Google Scholar]
  13. Zurgil N., Bakimer R., Tincani A., Faden D., Cohen J., Lorber M., Valesini G., Shoenfeld Y. Detection of anti-phospholipid and anti-DNA antibodies and their idiotypes in newborns of mothers with anti-phospholipid syndrome and SLE. Lupus. 1993 Aug;2(4):233–237. doi: 10.1177/096120339300200405. [DOI] [PubMed] [Google Scholar]
  14. el-Roeiy A., Gleicher N., Isenberg D., Kennedy R. C., Shoenfeld Y. A common anti-DNA idiotype and other autoantibodies in sera of offspring of mothers with systemic lupus erythematosus. Clin Exp Immunol. 1987 Jun;68(3):528–534. [PMC free article] [PubMed] [Google Scholar]

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