Clinical associations of anti‐lamin autoantibodies

Background : The clinical associations of anti‐lamin autoantibodies were first described in 1973. Since then a number of individual case reports and two small series have been published. These have suggested an association with connective tissue disorders and autoimmune liver disease. Aims : To identify the clinical and laboratory associations of anti‐lamin autoantibodies in an Australian population. Methods : Retrospective review of routine antinuclear antibody testing between 1990–1994 for characteristic linear staining of nuclear envelope on indirect immunofluorescence on HEp‐2 cells with clinical status defined by retrospective review of case records. Results : Twenty‐eight patients were identified and the clinical status of 27 patients defined. Eleven patients had associated IgG anti‐cardiolipin antibodies; anti‐phospholipid syndrome was present in nine. Seven further patients had liver disease; five had autoimmune liver disease, with associated autoantibodies. The remaining nine patients had a diverse group of diseases. There was no correlation between the titre of the autoantibody and clinical status. An association with anti‐cardiolipin antibodies was found although the cause remains obscure. Conclusion : Anti‐lamin autoantibodies, as identified by indirect immunofluorescence, are associated with a diverse group of diseases but particularly with anti‐phospholipid syndrome and liver disease. Testing for anti‐phospholipid antibodies and more specific markers of systemic lupus erythematosus and autoimmune disease, for example anti‐dsDNA antibodies, anti‐smooth muscle antibodies and anti‐mitochondrial antibodies should be pursued when anti‐lamin autoantibodies are detected. (Aust NZ J Med 1996; 26: 162–166.)