Antibodies to histone in the pediatric population: a retrospective chart review
Abstract Background Antibodies to histone have been associated in the adult literature with systemic lupus erythematosus(SLE) and drug induced lupus(DILE). Little data is available regarding the spectrum of pathology that antibodies to histone encompass in the pediatric population. Prior studies sug...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Pediatric Rheumatology Online Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12969-023-00821-y |
| _version_ | 1797836588425674752 |
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| author | C. Matt Justice Terry L. Moore |
| author_facet | C. Matt Justice Terry L. Moore |
| author_sort | C. Matt Justice |
| collection | DOAJ |
| description | Abstract Background Antibodies to histone have been associated in the adult literature with systemic lupus erythematosus(SLE) and drug induced lupus(DILE). Little data is available regarding the spectrum of pathology that antibodies to histone encompass in the pediatric population. Prior studies suggest an association with SLE, juvenile idiopathic arthritis(JIA), uveitis and linear scleroderma. Methods Patient charts were reviewed that contained positive anti-histone antibody testing during a consecutive three year period. Patient diagnosis along with the presence of: anti-histone antibody titer, ANA, and the presence of other autoantibodies to SSA, SSB, Sm, RNP, dsDNA and chromatin were obtained. The frequency of SLE, JIA and DILE was further investigated in specific subsets. Results 139 individual charts were reviewed containing 41 different diagnoses. The most common diagnosis was hypermobility arthralgia with 22 patients. The most frequent rheumatologic diagnosis was JIA(nonsystemic) with 19. 13 patients in this study were diagnosed with SLE and 2 with DILE. 18 patients had other autoantibody production, of these, 11 had SLE or DILE. Only one of 62 patients with a weak antihistone antibody titer(1.0-1.5) was diagnosed with SLE. When strong titers are present(> 2.5), the antihistone antibody test was associated with a greater than 50% incidence of an underlying rheumatologic disease and ten times higher incidence of SLE than a weak titer. In regards to the frequency of SLE, there was a statistically significant difference between weak and moderate titers and between weak and strong titers. Conclusion The presence of anti-histone antibody was observed in a variety of diagnoses in the pediatric population. Overall, the presence of anti-histone antibodies appears to have poor diagnostic utility for any specific condition. However, diagnostic utility for SLE does appear to improve with higher titers, when combined with other autoantibody positivity. Strength of titer did not appear to be a factor for JIA, but was the most frequently observed rheumatologic disease in this study. |
| first_indexed | 2024-04-09T15:12:25Z |
| format | Article |
| id | doaj.art-fc507f6e492e4a199006671aedd791df |
| institution | Directory Open Access Journal |
| issn | 1546-0096 |
| language | English |
| last_indexed | 2024-04-09T15:12:25Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj.art-fc507f6e492e4a199006671aedd791df2023-04-30T11:10:12ZengBMCPediatric Rheumatology Online Journal1546-00962023-04-012111610.1186/s12969-023-00821-yAntibodies to histone in the pediatric population: a retrospective chart reviewC. Matt Justice0Terry L. Moore1Division of Rheumatology and Pediatric Rheumatology, Saint Louis University School of MedicineDivision of Rheumatology and Pediatric Rheumatology, Saint Louis University School of MedicineAbstract Background Antibodies to histone have been associated in the adult literature with systemic lupus erythematosus(SLE) and drug induced lupus(DILE). Little data is available regarding the spectrum of pathology that antibodies to histone encompass in the pediatric population. Prior studies suggest an association with SLE, juvenile idiopathic arthritis(JIA), uveitis and linear scleroderma. Methods Patient charts were reviewed that contained positive anti-histone antibody testing during a consecutive three year period. Patient diagnosis along with the presence of: anti-histone antibody titer, ANA, and the presence of other autoantibodies to SSA, SSB, Sm, RNP, dsDNA and chromatin were obtained. The frequency of SLE, JIA and DILE was further investigated in specific subsets. Results 139 individual charts were reviewed containing 41 different diagnoses. The most common diagnosis was hypermobility arthralgia with 22 patients. The most frequent rheumatologic diagnosis was JIA(nonsystemic) with 19. 13 patients in this study were diagnosed with SLE and 2 with DILE. 18 patients had other autoantibody production, of these, 11 had SLE or DILE. Only one of 62 patients with a weak antihistone antibody titer(1.0-1.5) was diagnosed with SLE. When strong titers are present(> 2.5), the antihistone antibody test was associated with a greater than 50% incidence of an underlying rheumatologic disease and ten times higher incidence of SLE than a weak titer. In regards to the frequency of SLE, there was a statistically significant difference between weak and moderate titers and between weak and strong titers. Conclusion The presence of anti-histone antibody was observed in a variety of diagnoses in the pediatric population. Overall, the presence of anti-histone antibodies appears to have poor diagnostic utility for any specific condition. However, diagnostic utility for SLE does appear to improve with higher titers, when combined with other autoantibody positivity. Strength of titer did not appear to be a factor for JIA, but was the most frequently observed rheumatologic disease in this study.https://doi.org/10.1186/s12969-023-00821-yHistonePediatricSystemic lupus erythematosus(SLE)Juvenile idiopathic arthritis(JIA)Drug induced lupus(DILE)Uveitis |
| spellingShingle | C. Matt Justice Terry L. Moore Antibodies to histone in the pediatric population: a retrospective chart review Pediatric Rheumatology Online Journal Histone Pediatric Systemic lupus erythematosus(SLE) Juvenile idiopathic arthritis(JIA) Drug induced lupus(DILE) Uveitis |
| title | Antibodies to histone in the pediatric population: a retrospective chart review |
| title_full | Antibodies to histone in the pediatric population: a retrospective chart review |
| title_fullStr | Antibodies to histone in the pediatric population: a retrospective chart review |
| title_full_unstemmed | Antibodies to histone in the pediatric population: a retrospective chart review |
| title_short | Antibodies to histone in the pediatric population: a retrospective chart review |
| title_sort | antibodies to histone in the pediatric population a retrospective chart review |
| topic | Histone Pediatric Systemic lupus erythematosus(SLE) Juvenile idiopathic arthritis(JIA) Drug induced lupus(DILE) Uveitis |
| url | https://doi.org/10.1186/s12969-023-00821-y |
| work_keys_str_mv | AT cmattjustice antibodiestohistoneinthepediatricpopulationaretrospectivechartreview AT terrylmoore antibodiestohistoneinthepediatricpopulationaretrospectivechartreview |