Clinical Implications of Antinuclear Antibody (ANA) and Anti-Ro/Anti-La Antibody Profile in Patients with Primary Sjögren's Syndrome: A Multicenter Cross-Sectional Study of a National Egyptian Cohort

Abstract

Background: Primary Sjögren's Syndrome (pSS) is a systemic autoimmune disease that predominantly impacts the exocrine glands. It is characterized by a diverse clinical manifestation and the existence of various autoantibodies. There is a lack of studies assessing the primary pSS phenome driven by anti-Sjögren syndrome autoantibodies in Africa, particularly in Egypt.

Objective: This study aims to evaluate the clinical implications of antinuclear antibodies (ANA) and anti-Ro/anti-La autoantibodies in an Egyptian national cohort of pSS patients.

Methods: We conducted a cross-sectional analysis of pSS patients, comparing clinical manifestations and disease severity based on serological profiles.

Results: A total of 301 pSS patients (mean age: 45.6±10.2 years; F:M ratio 7.4:1) were included. Patients with positive ANA (59.5%) had a higher prevalence of anti-Ro (p=0.001) and anti-La (p=0.0001) antibodies, along with lower rates of dry eyes (p=0.04) and enlarged parotid glands (p=0.001). Corticosteroid and azathioprine use was more frequent in ANA-positive patients (p=0.017, p=0.003). Double-positive anti-Ro/anti-La patients exhibited higher rates of dry mouth (p=0.045), articular manifestations (p<0.0001), fibromyalgia (p=0.001), RF positivity (p<0.001), and C4 consumption (p<0.001).

Conclusion: Patients with pSS exhibit distinct clinical and laboratory profiles based on their autoantibody status, emphasizing the importance of immunological assessment for disease management.

Keywords: Egypt; anti-La; anti-Ro; antinuclear antibody; primary Sjögren’s syndrome.

Figure 1

The flowchart of the study. Flowchart illustrating the study design, patient inclusion process, and final stratification by autoantibodies positivity.