CLINICAL ASSOCIATIONS OF ANTI-LAMIN AUTOANTIBODIES

Background: The clinical associations of anti-lamin autoantibodies wer e first described in 1973. Since then a number of individual case repo rts and two small series have been published. These have suggested an association with connective tissue disorders and autoimmune liver dise ase. Aims: To identify the clinical and laboratory associations of ant i-lamin autoantibodies in an Australian population. Methods: Retrospec tive review of routine antinuclear antibody testing between 1990-1994 for characteristic linear staining of nuclear envelope on indirect imm unofluorescence on HEp-2 cells with clinical status defined by retrosp ective review of case records. Results: Twenty-eight patients were ide ntified and the clinical status of 27 patients defined. Eleven patient s had associated IgG anti-cardiolipin antibodies; anti-phospholipid sy ndrome was present in nine. Seven further patients had liver disease; five had autoimmune liver disease, with associated autoantibodies. The remaining nine patients had a diverse group of diseases. There was no correlation between the titre of the autoantibody and clinical status . An association with anti-cardiolipin antibodies was found although t he cause remains obscure. Conclusion: Anti-lamin autoantibodies, as id entified by indirect immunofluorescence, are associated with a diverse group of diseases but particularly with anti-phospholipid syndrome an d liver disease. Testing for anti-phospholipid antibodies and more spe cific markers of systemic lupus erythematosus and autoimmune disease, for example anti-dsDNA antibodies, anti-smooth muscle antibodies and a nti-mitochondrial antibodies should be pursued when anti-lamin autoant ibodies are detected.