Anti-pseudo PCNA auto antibodies: Clinical and biological correlates in a single center cohort of 48 patients

Anti-pseudo PCNA (proliferating cell nuclear antigen) antibodies (Abs) demonstrate a polymorphic dense fine speckling in S/G2 phase Hep-2 cells and a negative staining of the chromosomal region by indirect immunofluorescence antinuclear staining. We described a retrospective analysis (2006–2012) of 48 patients presenting with anti-pseudo PCNA Abs. All patients were selected via the Immunology Laboratory of the Hopitaux Universitaires of Strasbourg (France) and most of their clinical and biological characteristics were collected. The average age was 57.7 years and the sex ratio was 39 females/9 males. Autoimmune diseases were frequently associated (70.3%) likely because of a selection bias, but with predominantly Sjögren syndrome (28.9%). We did not find any significant association with Systemic Lupus Erythematosus (SLE) or viral hepatitis as suggested for anti-PCNA Abs. Moreover, 14.8% patients had personal history of cancer. Arthralgia were the most frequent clinical manifestations as described for anti-PCNA Abs; 47.9% of the entire lot presented with diverse neurological involvement, and 27.1% displayed cutaneous lesions. No renal disease was detected in any patient. The most frequent associated auto Abs were anti-Ro Abs. Considering treatment before the first positive determination, 31.3% patients were treated with corticosteroids, and none with immunosuppressive therapy. Literature data already suggested that anti-PCNA Abs could be sensitive to immunosuppressors. As a conclusion, this study is to our knowledge, the first which describes clinical and biological correlates of anti-pseudo PCNA Abs.