FRI0258\u2005ANTI-RO/SSA POSITIVITY, ANTI-AQUAPORIN4 ANTIBODIES AND CENTRAL NERVOUS SYSTEM INVOLVEMENT: A RETROSPECTIVE STUDY ON A CONTROVERSIAL CORRELATION

Abstract

Background: Different neurological manifestations have been observed in 20-25% of patients affected by Sjögren’s syndrome (SS). Among them, CNS demyelinating diseases, Neuromyelitis optica (NMO) and NMO spectrum disorders (NMOSD) with anti-aquaporin4 antibodies (anti-AQP4) positivity have been described. Objectives: The aim of the present study was to assess the clinical charachteristics and seroimmunological correlations in patients with Ro-SSA antibodies and Central and peripheral nervous system (CNS and PNS) involvement. Methods: We retrospectively reviewed clinical records, laboratory and Magnetic Resonance Imaging (MRI) reports of patients followed-up at a tertiary level immunorheumatology and neuroimmunology clinic. We included patients showing an anti-SSA antibodies positivity and concomitant neurological symptoms at diagnosis. We excluded patients fulfilling SLICC criteria for SLE. We recorded clinical and laboratory and MRI data for all patients. Results: Out of 9598 clinical records reviewed, we identified 511 patients with anti Ro/SSA positivity. 11 patients had prevalent neurological manifestations. 8 (72.7%) patients were women. The median age was 56 [IQR 31] years. CNS involvemente was the main clinical feature in 7 patients (63.6%); 3 of them (27.3%) also had PNS manifestations. 4 patients showed exclusively PNS involvement. 3 subjects fulfilled criteria for SS while 8 patients were classified as undifferentiated connective tissue disease. 7 patients underwent spinal tap which reported inflammatory alterations (high levels of CSF proteins in 2 subjects and oligoclonal bands in 4 patients). Median Erythrocyte sedimentation rate (ESR) was 12 mm/h [IQR 18] while median C- Reactive protein was 0.34 mg/dL [IQR 0.32]. There was not complement deficiency in any patient. With regard to the tested autoantibodies, 2 subjects showed also anti-La positivity. Out of the 4 patients tested for anti-AQP4 none was positive, even if 2 patients had NMODSD. Conclusion: Anti-SSA positive may show a wide spectrum of neurological manifestations; CNS involvement was not associated to anti-AQP4 positivity in our cohort, even in patients with NMO/NMOSD. Further investigations are required to better disclose this association and to search for novel autoantibodies. \nDisclosure of Interests: None declared