Anticorpos antinucleares e antifosfolípides em filhos de mães com lúpus eritematoso sistêmico

Abstract

Introduction: The Systemic lupus erythematosus (SLE) is a multisystem disease, chronic and autoimmune, which is characterized by the presence of various circulating antibodies. It mainly affects women of reproductive age, but the SLE women usually have the fertility preserved. There are few studies evaluating the children of these mothers and the dosage of autoantibodies has not been systematically evaluated in these children. Objectives: To evaluate the presence of antinuclear antibodies (ANA) and antiphospholipid (AAF) in children of mothers with SLE and at aged between two months and 12 years. Materials and Methods: Prospective cohort study, from 12th April 2013 to 30th April 2014. The selection of mothers was held at SLE Clinic of the Rheumatology Department of NHU / UFMS. It was performed a collecting of children's blood samples for analysis of ANA and AAF and when positive, repeated every three months until seroreversion or fourth collecting within the period of one year. In the positivity of ANA, in the second collecting were measured the anti-Sm, anti-RNP, anti-DNA, anti-SSa and anti-SSB. Results: 133 children were selected, with ratio of F:M of 1.7: 1. Eighteen children have presented positive ANA (13.5%) and the main pattern found was the nuclear fine speckled (NFS) with titers from 1/160 to 1/5120. All these children became negative to the third collection, except four, but no clinical changes or development. Nineteen children (14%) showed positive AAF (the most frequent was the ACL IgG) and became negative after the third collection. Two children presented Neonatal lupus erythematosus with cutaneous manifestations (1,5%). Neurological alterations were detected in two children with positive ANA and three children with positive AAF. Conclusions: It was observed that the four children maintained ANA positive during follow-up and they must be followed for long term in order to verify if they will develop some autoimmune disease.