Background: The diagnosis of systemic autoimmune diseases (SAID) is challenging, due to overlapping features with other non-immune disorders. Antinuclear antibodies (ANA) /anti-cellular antibodies are the sensitive screening tests but anti-double-stranded-deoxyribonucleic acid-antibody (anti-ds-DNA), and ANA-speci c antibodies are speci c for SAID. We aimed to look at ANA-speci c antibodies in our patients and correlated them with ANA patterns, anti-ds-DNA, and clinical diagnosis for proper interpretation and better patient management cost-effectively.Methods: A retrospective data analysis of 641 patients was done (1st February 2019 to 31st -July-2021) who were tested for ANA-speci c antibodies at
Background:The diagnosis of autoimmune diseases (AID) is challenging, due to overlapping features with other non-immune disorders. Anti-nuclear antibodies (ANA) /anti-cellular antibodies are the sensitive screening tests but anti-double-stranded-deoxyribonucleic-acid-antibody (anti-ds-DNA), and anti-extractable nuclear antigens (anti-ENA) are specific for AIDs. We aimed to look at anti-ENA in our patients and correlated them with ANA patterns, anti-ds-DNA and clinical diagnosis for proper interpretation and better patient management cost-effectively. Methods:A retrospective data analysis of 654 patients was done (1st-February-2019 to 31st –July-2021) who were tested for anti-ENA at the Immunology Department of Indus Hospital and Health Network. ANA and anti-ds-DNA results and clinical diagnosis were also analyzed for anti-ENA-positive patients. The statistical analysis was performed using IBM SPSS 24.0, P < 0.05.was considered statistically significant.Results:Anti-ENA was positive for at least one autoantibody in 245 (38.2%). ANA was positive in 97% of these patients (P=0.000) with speckled and homogenous as most predominant ANA patterns (63% and 33% respectively). Anti-SSA was the most common anti-ENA (n=50%) followed by anti-histones (23%), anti-Sm/RNP (26%), anti-nucleosome (22%). Among ANA-negative patients, anti-SSA was most common (n=5). Anti-ds-DNA was found in 66% of SLE patients. 14% of patients did not have a confirmed diagnosis before anti-ENA testing.Conclusions: Anti-ENA, ANA, and anti-ds-DNA antibodies are essential for AID diagnosis. However, their testing repertoire should follow an algorithm comprising of clinical features, followed by ANA results with nuclear, mitotic, and cytoplasmic patterns, anti-ENA, and anti-ds-DNA for a more meaningful, and cost-effective diagnostic approach.
Background: The diagnosis of systemic autoimmune diseases (SAID) is challenging, due to overlapping features with other non-immune disorders. Anti-nuclear antibodies (ANA) /anti-cellular antibodies are the sensitive screening tests but anti-double-stranded-deoxyribonucleic acid-antibody (anti-ds-DNA), and ANA-specific antibodies are specific for SAID. We aimed to look at ANA-specific antibodies in our patients and correlated them with ANA patterns, anti-ds-DNA, and clinical diagnosis for proper interpretation and better patient management cost-effectively. Methods: A retrospective data analysis of 641 patients was done (1st February 2019 to 31st –July-2021) who were tested for ANA-specific antibodies at the Immunology Department of Indus Hospital and Health Network. ANA and anti-ds-DNA results and clinical diagnosis were also analyzed for ANA-specific antibodies-positive patients. Descriptive data were presented in mean ±standard deviation and frequency percentages whereas inferential data were analyzed with a chi-square test for association between ANA-specific antibodies status, ANA, anti-ds-DNA, and clinical features. Results: ANA-specific antibodies test revealed positivity for at least one autoantibody in 245 (38.2%) patients. Of these, ANA was tested in 206 patients reactive for ANA-specific antibodies and found positive in 195 (95%) as compared to negative (<0.001). Speckled and homogenous were predominant ANA patterns in ANA-specific antibodies-positives (56% and 42% respectively). Multiple ANA patterns were found in 18 patients most commonly with systemic lupus erythematosus (SLE) and mixed connective tissue disorder (MCTD). Anti-SSA were the most common ANA-specific antibodies (50%) and was mostly found in sera with speckled (61/97) and homogenous (38/97) patterns and associated mostly with SLE (48%) and Sjogren’s syndrome (86%). Among ANA-negative patients, anti-SSA were the most common antibodies (n=5). Anti-ds-DNA was found in 66% of SLE patients along with another ANA-specific antibody. Conclusions: This study showed that testing for ANA-specific antibodies cannot be gated on ANA patterns. Also, there is a redundancy of these antibodies with various clinical diagnoses. Moreover, they are useful in making a diagnosis in ANA-negative patients as well with clinical suspicion.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.