Systemic lupus erythematosus with anti-Ro antibodies: clinical, histologic and immunologic findings. Report of three cases.

Detection of anticytoplasmic antibodies of Ro specificity has been a valuable aid in identification of a subpopulation of patients with systemic lupus erythematosus (SLE). Characteristics of this group of patients have been dermatosis, photosensitivity, hypergammaglobulinemia, positive rheumatoid factor, and usually absence of fluorescent antinuclear antibodies done by conventional methods. The findings of these three patients add further evidence that, in addition to presence of other manifestations of SLE, the dominant feature is a cutaneous eruption. This became marked and disseminated during exacerbations usually following sun exposure. Such features distinguish these patients from those with discoid lupus erythematosus (DLE) or classical SLE, although at times features of either may be present. Concomitantly, there were selective histopathologic and immunopathologic changes. An unusual finding was a variability in lupus band test dependent upon the state of the disease. Likewise, serologic reactions exhibited a wide range of variability. The results suggest three phases of the disease: chronic active, acute, and treated inactive. Despite acute episodes, including development of nephrotic syndrome in one patient, there was satisfactory response to moderately high doses of corticosteroids and antimalarials.