From the Guidelines
Anti-SSB/La is not a primary indicator for Systemic Lupus Erythematosus (SLE) management.
Indications for Anti-SSB/La
- Anti-SSB/La antibodies have been associated with the occurrence of neonatal lupus 1.
- These antibodies may have prognostic value in SLE 1, but their role in monitoring disease activity is not well established.
SLE Management
- The management of SLE involves monitoring clinical signs (rashes, arthritis, serositis, neurological manifestations, and seizures/psychosis), routine laboratory tests (CBC, serum creatinine, proteinuria, and urinary sediment), and immunological tests (serum C3, anti-dsDNA, anti-Ro/SSA, anti-La/SSB, antiphospholipid, anti-RNP) 1.
- Imaging (brain MRI) and pathology (renal biopsy) may provide additional prognostic information in selected patients 1.
Laboratory Assessment
- Anti-dsDNA antibody titres may correlate with disease activity and active renal disease, but treating patients with anti-dsDNA antibodies in the absence of clinical activity is not recommended 1.
- Complement levels and CRP may be associated with active disease, but their predictive value for disease flares is limited 1.
- Anti-phospholipid (aPL) antibodies have been associated with general disease activity, thrombotic manifestations, damage development, and pregnancy complications 1, and their presence modifies the recommendations for SLE management 1.
From the Research
Association of Anti-SSB/La with Systemic Lupus Erythematosus (SLE)
- The presence of anti-SSB/La antibodies in SLE patients has been investigated in several studies 2, 3, 4, 5, 6.
- A study published in 2017 found that anti-La/SSB antibodies were present in 16% of 645 childhood-onset SLE patients and were associated with mild manifestations, particularly cutaneous and musculoskeletal 2.
- Another study published in 2013 found that anti-SSB antibodies were present in 25.7% of 74 SLE patients and were associated with cheek erythema, alopecia, serositis, secondary Sjögren's syndrome, leukocytopenia, and elevated immunoglobulin G 3.
- The specificity of anti-SSB antibodies for detecting SLE was found to be 96.7% in the same study 3.
Clinical Manifestations
- The presence of anti-SSB/La antibodies has been associated with various clinical manifestations in SLE patients, including:
- Cutaneous manifestations such as malar rash, photosensitivity, and cutaneous vasculitis 2
- Musculoskeletal involvement 2
- Alopecia 3
- Serositis 3
- Secondary Sjögren's syndrome 3, 4, 5
- Leukocytopenia 3
- Elevated immunoglobulin G 3