A Hospital-Based Insight into the Antinuclear Antibody Patterns in Autoimmune Disorders

Abstract

Background The incidence of autoimmune disorders has seen a rise in India in recent times. The symptoms and signs of these conditions are caused by a systemic autoimmune response, essentially characterized by the expression of the antinuclear antibodies (ANA). Presence of ANA in serum of patient could be the prime evidence of an autoimmune disorder. Aim This study aimed to determine the antibody patterns and assess the clinical significance of ANA in patients of a teaching tertiary care hospital of central India. Material and Methods This retrospective cross-sectional data analysis study retrieved 538 reports of individuals, who were prescribed the ANA test by indirect immunofluorescence assay over a period of 11 months, from the archives of the Department of Biochemistry. For continuous data, student t-test was used while Chi-square and Fisher exact was conducted for categorical data. A p value less than 0.05 were taken as significant. Results Out of the 538 patients investigated for ANA testing by indirect immunofluorescence assay, 33% were positive, among which 74% were female, and majority belonged to the young adult age group. The most common pattern identified was nuclear, subpattern nuclear speckled. Conclusion A high-ANA pattern positivity could be related to a high-autoimmunity prevalence in this region, and also promotes its use as a tool of evidence of suspected autoimmune disorders.

Determination and Prevalence of Antinuclear Antibody (ANA) Patterns in Autoimmune Disorders in a Tertiary Care Hospital, Jaipur

“…The nuclear speckled pattern is nearly evenly distributed in all told age groups. The results of present study were almost similar to study done by Minz R W et al in Chandigarh and Gupta P et al in Raipur, showing high-ANA positivity in SLE and DLE, scleroderma and rheumatoid patients [15,3] . However, the foremost common pattern related to SLE was nuclear homogenous in contrast to nuclear speckled in their studies.…”

“…It's often thought that the uncommon patterns haven't any role to play in diagnosis. [15,3] However, the current study and studies done by Chanwit et al and Sener et al found the rare ANA patterns in significant number, and also disease conditions related to them, especially chronic hepatic conditions and carcinoma. [24,25] The cytoplasmic patterns also are considered non disease-specific but their significance shouldn't be ignored, as stated by Chanwit et al, since they could also point to certain undetected conditions.…”

“…In Raipur Chhattisgarh by Gupta P et al the frequency of positivity was almost like in this study. [3] In the study conducted in Chandigarh by Minz RW et al lesser positivity rate compared with present study was noted [15] . Although the results of those studies are often considered as prevalence, however, the population-based studies showed mixed results wherein Akmatov M K et al in Germany and Satoh M et al in U.K found ANA positivity rate to be 33% and 13.8%, respectively [16,17] while Sremec Nada T et al in China and Weyand Banhuk F et al within USA demonstrated much lower prevalence.…”

“…Although a collection of tests are available for ANA detection, the indirect immunofluorescence (IIF)-ANA on HEp-2 cells persists to be the gold standard. [3] According to the currently valid international consensus, the International Consensus on ANA Patterns (ICAP ) [4] , there are 29 recognised discrete HEp-2 cell IIF patterns that are divided into nuclear, cytoplasmic and mitotic subtypes.…”

The Clinical, Radiological, and Laboratory Profile of Patients With Interstitial Pneumonitis With Autoimmune Features From India: An Observational, Cross-Sectional Study

“…One US study had a positive ANA in 77% of their patients while the other one had a positive ANA in approximately half their cohort. This heterogeneity may be due to the fact that ANA positivity is inherently higher in the Indian population as compared to the population of the US with previous studies reporting 33% positivity in the normal population in India as compared to around 14% in the US [ 10 , 11 ]. In our study, the anti-AMA-M2 antibody was found in 25% of patients while the anti-SSA antibody was found in 16.7% and a small proportion of patients had the other antibodies we tested for.…”