Anti-Ro52 Antibodies – Independent Risk Factors for the Development of Interstitial Lung Disease in Systemic Sclerosis

Alexandra-Ioana Caplea-Tonica⁽¹⁾, Rasha-Ioana Ramoiu-Shehada⁽¹⁾, Ananu Flerentin Vreju^(1,2), Anca Emanuela Musetescu^(1,2,*), Paulina Lucia Ciurea⁽²⁾, Alesandra Florescu^(1,2)

1)Emergency Clinical County Hospital of Craiova , Department of Rheumatology, Craiova, Romania
2)University of Medicine and Pharmacy of Craiova, Department of Rheumatology, Craiova, Romania

Introduction: Systemic sclerosis (SSc) is a multisystem autoimmune disease in which interstitial lung disease (ILD) is a leading cause of morbidity and mortality. Anti-Ro52 antibodies have been associated with a higher prevalence of ILD, greater fibrosis burden, and poorer outcomes, yet their role as isolated biomarkers in SSc remains under investigation.
Case Report: We present a 64-year-old female with hypothyroidism who initially presented with polyarthralgia of the small joints without overt synovitis. Six months later, she developed Raynaud’s phenomenon, puffy hands, and exertional dyspnea. Capillaroscopy showed an active scleroderma pattern, and serology revealed isolated anti-Ro52 antibody positivity. High-resolution computed tomography demonstrated nonspecific interstitial pneumonia (NSIP) with 25–30% pulmonary involvement, preserved diffusion capacity, and early pulmonary arterial hypertension. Limited cutaneous SSc with ILD was diagnosed, and treatment with mycophenolate mofetil, low-dose methylprednisolone, and vasodilators was initiated. Over two years of follow-up, HRCT showed a reduction in ILD extent to 10%, with stable DLCO (77–83%).
Conclusions: This case highlights isolated anti-Ro52 positivity as a potential biomarker for ILD in SSc. Extended autoantibody testing may enable earlier identification of high-risk patients. Prompt immunosuppressive therapy initiation can stabilize or improve lung involvement, potentially preventing irreversible pulmonary damage.

Keywords: systemic sclerosis, anti-Ro52 antibodies, interstitial lung disease

Corresponding author(s): Anca Emanuela Musetescu, University of Medicine and Pharmacy of Craiova, Department of Rheumatology; e-mail: anca.musetescu@umfcv.ro