INVIVO ANTI-NUCLEAR ANTIBODIES IN EPITHELIAL BIOPSIES IN SLE AND OTHER CONNECTIVE-TISSUE DISEASES

  • 1 January 1979
    • journal article
    • research article
    • Vol. 38  (3) , 424-435
Abstract
In vivo anti-nuclear antibody (ANA) was observed by direct immunofluorescence microscopy in epithelial cell nuclei in 44 biopsies from 33 patients. The tissue containing the ANA was macroscopically normal in 27 patients. The 33 patients with in vivo biopsy ANA included 23 with SLE (systemic lupus erythematosus); 3 with mixed connective tissue disease; 2 each with multisystem Sjogren''s syndrome, dermatomyositis and progressive systemic sclerosis; and 1 with rheumatoid arthritis. Features of sicca syndrome were noted in 17 patients. The patterns of the in vivo biopsy ANA in the 33 patients were speckled (21), homogeneous (6), nodular (2) and both speckled and homogeneous (4). Complement was not detected in the epithelial cell nuclei. Immunoglobulin(s) and/or complement were deposited along the dermoepidermal junction in 32 of the 44 biopsies and in dermal blood vessels in 22 biopsies. Each patient had serum ANA against rat liver substrate; 27 had high titer ANA (1 in 1000 or greater). Elevated levels of DNA-binding were found in 20 patients (61%) but the level of DNA-binding did not correlate with the intensity of in vivo biopsy ANA staining. Serum antibody to ribonucleoprotein (RNP) was present in 8 of the 23 patients tested (35%); all 8 had clinical features of sicca syndrome. Hypocomplementemia was found in 13 patients (40%), all of whom had active SLE. In vivo biopsy ANA appears to be a real phenomenon of unknown etiology and not an artifact which is found in some patients with active multisystem autoimmune disease, especially SLE.