Anti-Ro Positivity in Systemic Lupus Erythematosus: Association with Clinical Phenotypes and Serological Profile

Objective: To determine the association of anti-Ro antibody with the clinical features and serology in systemic lupus erythematosus (SLE) patients. Methods: This retrospective observational study enrolled 158 SLE patients at the Rheumatology Department, Fauji Foundation Hospital, from May 1 to October 31, 2023. Demographic and clinical data were collected. Patients were stratified by anti-Ro (positive vs. negative), concomitant anti-La (anti-Ro[Formula: see text]/anti-La[Formula: see text], anti-Ro[Formula: see text]/anti-La[Formula: see text], anti-Ro[Formula: see text]/anti-La[Formula: see text], and anti-Ro[Formula: see text]/anti-La[Formula: see text]), and anti-nuclear antibody (ANA) status (positive vs. negative). Mann-Whitney U and Chi-square tests were employed for comparisons, with statistical significance set at p<0.05. Results: The study population consisted mainly of females (98.7%), with a median age of 30 years. Anti-Ro[Formula: see text] patients (46.8%) exhibited higher discoid rash (16.2% vs. 6%, p [Formula: see text] 0.04), sicca symptoms (52.7% vs. 31%, p [Formula: see text] 0.005), and anemia (71.6% vs. 56%, p [Formula: see text] 0.04). No significant differences were observed in nephritis (29.7% vs. 34.5%, p [Formula: see text] 0.52) or neurological disease (9.5% vs. 11.9%, p [Formula: see text] 0.69) between the two groups. The anti-Ro[Formula: see text]/anti-La[Formula: see text] group had higher myositis (20.6%), sicca symptoms (55.9%), and fever (70.6%) compared to other groups. The ANA[Formula: see text]/anti-Ro[Formula: see text] group (48.6%) had significant association with sicca symptoms (50.7%) and fever (64.2%). Conclusion: Anti-Ro[Formula: see text] SLE in South Asians is associated with sicca symptoms, anemia, fever, and myositis—findings critical for tailored management. Co-positivity with anti-La amplifies risks, warranting vigilant monitoring.