Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Serum Tumor Necrosis Factor alfa (TNF) Is Associated with Disease Activity in Juvenil Systemic Lupus Erythematosus (jSLE).

Postal,  Mariana, Pereira,  Karina, Pelicari,  Karina, Longhi,  Barbara, Marini,  Roberto, T. L. Costallat,  Lilian, Appenzeller,  Simone


To compare serum TNFa concentrations in jSLE patients, first-degree relatives and healthy volunteers. To determine clinical, laboratory and treatment features associated with TNFa in jSLE.


We included consecutive SLE patients with disease onset before the age of 16 (jSLE), first-degree relatives and age and healthy age and sex matched controls. SLE patients were assessed for the number of non-renal and renal American College of Rheumatology (ACR) criteria ever present, disease activity [SLE Disease Activity Index (SLEDAI)], damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)] and current drug exposures. Mood disorders were determined through Becks Depression and Becks Anxiety Inventory (BDI and BAI). TNFa levels were measured by enzyme-linked immunosorbent assay using commercial kits from R&D Systems (London, UK). Analysis of variance was used to compare TNFa concentrations between groups. We assessed the effects of various demographic and clinical factors and TNFa concentrations in jSLE using univariate analyses. Multivariate analysis was performed including sex, age, SLE duration, disease activity, damage, number of non-renal and renal ACR criteria ever present, and current drug exposures.


We included 50 jSLE (mean age 17.8±3.9), 45 first-degree relatives (mean age 40.2±6.3) and 49 controls (mean age 20.8±4.6). The mean level of serum TNFa was 4.6±9.6 pg/ml in jSLE, compared to 2.52 ± 2.7 pg/ml (p=0.15) in first-degree relatives and 1.8±1.9pg/ml in healthy controls (p=0.04). No difference between first-degree relatives and healthy controls was observed (p=0.13). TNFa concentrations correlated directly with SLEDAI scores (r=0.41; p=0.003), renal ACR criteria (r=0.3; p=0.05), and anxiety (r=0.34; p=0.03). No association between TNFa and SDI scores, depression, current use and dose of corticosteroids, hydroxychloroquine and immunosuppressants was observed. In adjusted analysis, TNFa levels was independently associated with SLEDAI scores (OR=3.1; 95%CI=1.6–6.5). When analyzing individual SLEDAI items, TNFa was associated with the presence of vasculitis (OR=3.9; 95%CI=1.3–4.9).


TNFa was significantly higher in jSLE patients when compared to healthy controls and was associated independently with disease activity in adjusted analysis. TNFa may be a useful marker for disease activity in jSLE, however longitudinal studies are necessary to determine if TNFa may predict flares in jSLE. The heterogeneity of clinical manifestations observed in SLE may be explained by different cytokine profile. Since TNFa was associated with the presence of vasculitis, anti-TNF treatment may be a treatment option for this manifestation.

To cite this abstract, please use the following information:
Postal, Mariana, Pereira, Karina, Pelicari, Karina, Longhi, Barbara, Marini, Roberto, T. L. Costallat, Lilian, et al; Serum Tumor Necrosis Factor alfa (TNF) Is Associated with Disease Activity in Juvenil Systemic Lupus Erythematosus (jSLE). [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1695
DOI: 10.1002/art.29460

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