| Abstract: | In sixteen patients, the relationship of epidermal nuclear immunofluorescence to the spectrum of connective tissue diseases and to serum antibodies was investigated. The clinical diagnoses were mixed connective tissue disease (7 patients), systemic lupus erythematosus (5 patients), scleroderma (3 patients) and rheumatoid arthritis (1 patient). Detailed serologic evaluation in 13 of the 16 patients revealed positive rheumatoid factor (7 patients), antinuclear antibody (13 patients), anti-DNA (2 patients), anti-n-RNP (11 patients), anti-Sm (2 patients), anti-SS-A (3 patients) and anti-RANA (5 patients). Anti-SS-B and anti-Scl-70 were absent in all. Epidermal nuclear immunofluorescence on skin biopsy correlated with serum anti-n-RNP and is a useful marker for mixed connective tissue disease. However, it did not appear to serve as a specific marker for any one connective tissue disease. We discuss the mechanism(s) for this immunofluorescent pattern and believe it is an in vivo phenomenon. |
