Anti‐DFS70 antibodies are associated with atopic dermatitis and can cause misdiagnosis of connective tissue disease

Abstract

Background and Objectives: Antinuclear antibodies (ANA) detected by HEp2 cell immunofluorescence staining are a characteristic finding in patients with connective tissue disease (CTD). However, even detection of highly elevated ANA is not conclusive for CTD and can result in misdiagnosis. Anti-DFS70 antibodies are ANA, which may also be highly elevated in people without CTD. Thus, we wanted to evaluate whether they could cause misdiagnosis of CTD. Since anti-DSF70 antibodies have been associated with atopic dermatitis (AD) in Japan, we wanted to investigate this association and its potential diagnostic relevance in Germany. Patients and Methods:We retrospectively analyzed data of 40 patients referred for first consultation on CTD and prospectively analyzed the prevalence of anti-DFS70 antibodies in 110 AD patients and 89 controls. Results: We could not confirm CTD in 75% of our referred patients, 26% of whom had already received systemic treatments. DFS70-typical fluorescence staining was detected in 35% and definitive anti-DFS70 antibodies in 12.5% of these patients. DFS70-typical fluorescence staining was detected in 22% of AD patients and anti-DFS70 antibodies in 10% (versus 5.6% and 0% in control patients, P < 0.001). Conclusions: Anti-DFS70 antibodies are significantly associated with AD and could be responsible for misdiagnosis of CTD.

Neuronal autoantibodies in the cerebrospinal fluid of 148 patients with schizophrenia and 151 healthy controls

“…Among these samples, the CSFs of nine patients with schizophrenia and six controls were positive for DFS70 antibodies. DFS70 is an antinuclear antibody that is associated with atopic dermatitis and asthma [ 34 , 35 ]. Although DFS70 has also been detected in healthy individuals, its pathogenic significance remains unclear [ 36 ].…”

Anti‐DFS70‐Antikörper sind mit atopischer Dermatitis assoziiert und können zur Fehldiagnose einer Kollagenose führen

“…Der Nachweis eines erhöhten ANA-Titers alleine hat eine sehr geringe Spezifität für die Diagnose einer Kollagenose, während der Nachweis erhöhter ANA und spezifischer Autoantikörper -wie zum Beispiel Anti-dsDNA-Antikörper -eine frühe Diagnose oder eine Prognose über den Krankheitsverlauf ermöglichen können. [1][2][3] Aus diesen Gründen sind ANA auch in anderen Fachrichtungen als der Rheumatologie zu einem beliebten diagnostischen Werkzeug geworden.…”

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“…A previous study reported that the presence of anti-DFS70 could be used as a biomarker to exclude SARDs from healthy individuals with positive ANA [32]. Knowing the serological and clinical profile of anti-DFS70-positive subjects may help to prevent unnecessary cases to specialists and requests for further testing in healthy individuals [32][33][34]. The gold standard for anti-DFS70 testing is the IIF assay.…”