ANTIRIBOSOMAL-P ANTIBODIES IN PEDIATRIC-PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS AND PSYCHOSIS

Objective. To study antibodies directed against ribosomal P proteins, a sensitive and specific marker of depression and psychosis in systemi c lupus erythematosus (SLE), in pediatric patients with SLE. Methods. One hundred six serum samples were obtained from 79 patients with SLE. Sixty age- and sex-matched control sera were obtained, and 12 samples were obtained from children with primary psychosis, Antibodies to rec ombinant ribosomal P (rRP) protein were detected using a standard enzy me-linked immunosorbent assay. Results. All 12 children with non-SLE-a ssociated psychosis had normal levels of anti-rRP antibodies, Elevated levels of anti-rRP were found in 11 of 64 pediatric SLE patients with out a history of psychosis (17%), In the group of 13 SLE patients with psychosis, 5 (38%) had increased anti-rRP antibody levels during the time of acute psychosis, and which significantly decreased during remi ssion, In addition, most of the SLE patients without a history of psyc hosis had a good correlation between anti-rRP antibody levels and dise ase activity, The patients with psychosis had significantly less renal involvement than the patients without a history of psychosis, This ap parent protection from renal disease was not related to the presence o r absence of either antiribosomal P or anti-DNA antibodies. Conclusion . Elevated serum levels of antibodies to ribosomal P protein can disti nguish SLE-associated psychosis from primary psychosis of childhood, I n SLE, elevated antiribosomal P antibody levels were not specific for psychosis. Serial assays were useful for monitoring the disease activi ty.