Autoantibodies in Pediatric SLE: Cluster Analysis and Clinical Associations, a Single Center Cohort Study

The study investigated the clustering of autoantibodies in 212 pediatric patients with systemic lupus erythematosus (pSLE) and their association with clinical manifestations. Cluster analysis identified three main clusters: Cluster 1 with anti-dsDNA and ANA antibodies, Cluster 2 with multiple autoantibodies including anti-dsDNA, ANA, anti-RNP, and anti-Sm, and Cluster 3 with anti-dsDNA, ANA, anti-cardiolipin, and anti-SSA antibodies. Significant differences among the clusters were found for hair loss (p=0.006), oral ulcers (p=0.024), arthritis (p=0.025), neurological symptoms (p=0.037), renal manifestations (p=0.003), and AIHA (p=0.012). The study concluded that distinct autoantibody clusters exist in pSLE, and determining the complete autoantibody profile is crucial for predicting the clinical course and identifying patients at risk of major organ involvement.