Incidental discovery of high systemic lupus erythematosus disease activity associated with cytomegalovirus viral activity |
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Authors: | Ben Yu-Jih Su Cheng-Yu Su Shan-Fu Yu Chung-Jen Chen |
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Institution: | (1) Division of Allergy, Immuology and Rheumatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, No.123, Ta-Pei Road, Niao-Sung Hsiang, 833 Kaohsiung Hsein, Taiwan;(2) Department of Pathology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung Hsein, Taiwan |
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Abstract: | We try to find the association of cytomegalovirus (CMV) infection and anti-β2 glycoprotein 1 autoantibodies (anti-β2 GP1),
a key antibody in antiphospholipid syndrome (APS), among systemic lupus erythematosus (SLE) and cerebral vascular accident
(CVA) patients. This retrospective study enrolled serum samples obtained from 87 SLE and 97 CVA patients who have been checked
for the existence of anti-β2 GP1. First, the prevalence rate of anti-CMV IgG and IgM in patients with and without anti-β2
GP1 were compared. Second, the prevalence of anti-CMV IgG and IgM were compared between SLE and CVA patients. Last, this study
analyzed the clinical characteristics and disease activity in SLE patients with positive anti-CMV IgM and IgG. No difference
existed in the prevalence rate of anti-CMV IgG and IgM between positive or negative anti-β2 GP1 serum samples in both SLE
and CVA patients. However, the prevalence of anti-CMV IgM was significantly higher in the SLE group than in the CVA group.
Severity of clinical features and SLEDAI scores were considerably higher in patients with positive anti-CMV IgM than in SLE
patients with negative anti-CMV IgM. Very impressively, all IgM-positive SLE samples (9/9) carrying highest levels of anti-CMV
IgG, indicated reactivation of the latent CMV infection. Hence, it suggests that CMV reactivation might contribute toward
the disease flare in some SLE patients. In future, a prospective and longitudinal study is stongly indicated. |
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Keywords: | Systemic lupus erythematosus Cytomegalovirus Anti-β 2 glycoprotein 1 autoantibodies Cerebral vascular accident |
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