IDENTIFICATION OF A SUBSET OF PATIENTS WITH SCLERODERMA WITH SEVERE PULMONARY AND VASCULAR-DISEASE BY THE PRESENCE OF AUTOANTIBODIES TO CENTROMERE AND HISTONE

Objectives-The role of autoantibodies in the investigation and managem ent of rheumatic diseases is well recognised. The objective of this st udy was to determine the clinical significance of the co-occurrence of antibodies to centromere and histone in serum samples from patients i nvestigated for systemic rheumatic diseases. Methods-Serum samples fro m 1316 consecutive patients were screened for antinuclear antibodies a nd the clinical findings in patients with antibodies to centromere alo ne were compared with those with antibodies to both centromere and his tone. Results-Twenty six patients had antibodies to centromere. Fourte en patients had antibodies to centromere alone and 12 patients had ant ibodies to centromere and histone. Four of the 12 patients with antibo dies to centromere and histone had diffuse scleroderma with severe pul monary or vascular disease. Conclusions-A subset of patients with scle roderma with antibodies to centromere and histone has been identified retrospectively, who have severe pulmonary or vascular disease. It wil l be of interest to follow up the clinical course of other patients wi th scleroderma who have both antibodies for the development of pulmona ry or vascular disease.