Anti-skin anti-intercellular antibodies in juvenile idiopathic arthritis

The aim of this work was to study the presence of anti-skin anti-intercellular (ASA-IC) and anti-basement membrane (ASA-BM) antibodies of the IgG class in patients with juvenile idiopathic arthritis (JIA) without clinical features of chronic vesicular-bullous diseases including pemphigus, pemphigoid and epidermolysis bullosa acquisita (EBA).

No D-penicillamine was used for JIA management in this group due to a risk of drug-induced pemphigus. Indirect immunofluorescence antibody test (IIF) and dual substrates of monkey and guinea pig esophagus sections were used for the detection and quantification of ASA-IC as well as ASA-BM antibodies. Overall ASA-IC were detected in 50 out of 57 studied patients' sera samples (87,7 %, P = 0,0003) ranging from 1:20 to ≤ 1:320 dilutions. Respective of the classification criteria for idiopathic arthritis of childhood ASA-IC were observed in 6/6 patients with systemic disease (100%, P = 0,029), 24/29 patients with RF negative polyarthritis (82,7 %, P = 0,01), 16/18 RF positive polyarthritis (88,9 %, P = 0,0077) as well as in a small cohort of patients with oligoarthritis (2/2) and psoriatic arthritis (2/2). However we have observed a high incidence of anti-skin anti-intercellular antibodies in a cohort of patients with JIA we suggest that subclinical pemphigus occuring in this group might be exacerbated with different stimulus including pemphigus inducing drugs. No ASA-BM antibody positivity was observed in a cohort of 57 studied patients.