Document Detail

Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases.
MedLine Citation:
PMID:  20954189     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To identify features of antinuclear antibody (ANA)-HEp-2 test results that discriminate ANA-positive healthy individuals and patients with autoimmune rheumatic diseases (ARDs).
METHODS: We sequentially retrieved data on 918 healthy individuals and 153 patients with ARDs after clinical assessment. ANA-positive healthy individuals for whom data were available were reevaluated after 3.6-5.0 years. An ANA-HEp-2 test result was considered positive when a clear ANA pattern was observed at 1:80 dilution in 2 distinct commercial HEp-2 slides by 2 blinded independent observers.
RESULTS: ANAs were present in 118 healthy individuals (12.9%) and 138 patients with ARDs (90.2%). The ANA titer was higher in patients with ARDs than in healthy individuals (P<0.001). The ANA pattern profile was distinct in the 2 groups. Nuclear homogeneous, nuclear coarse speckled, and nuclear centromeric patterns appeared exclusively in patients with ARDs. The nuclear dense fine speckled pattern occurred only in healthy individuals. The most frequent ANA pattern in both groups was the nuclear fine speckled pattern, which occurred at lower titer in healthy individuals than in patients with ARDs (P<0.001). Anti-extractable nuclear antigen was present in 1 healthy individual (anti-SSA/Ro) and in 52 patients with ARDs (37.7%). None of the 40 reevaluated healthy individuals developed ARDs, and 29 (72.5%) remained ANA positive. All healthy individuals who became ANA negative had an ANA titer of 1:80 at baseline.
CONCLUSION: Our findings suggest that the titer, and especially the pattern, on the ANA-HEp-2 test strongly enhances our ability to discriminate ANA-positive healthy individuals and patients with ARDs.
Henrique A Mariz; Emília I Sato; Silvia H Barbosa; Silvia H Rodrigues; Alessandra Dellavance; Luis E C Andrade
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  63     ISSN:  1529-0131     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-04     Completed Date:  2011-01-28     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  191-200     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 by the American College of Rheumatology.
Universidade Federal de São Paulo, São Paulo, Brazil.
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MeSH Terms
Age Factors
Antibodies, Antinuclear / immunology*
Autoimmune Diseases / diagnosis,  immunology*
Blotting, Western
Middle Aged
ROC Curve
Rheumatic Diseases / diagnosis,  immunology*
Statistics, Nonparametric
Reg. No./Substance:
0/Antibodies, Antinuclear
Comment In:
Arthritis Rheum. 2011 Dec;63(12):4036-7; author reply 4037-8   [PMID:  22127717 ]
Arthritis Rheum. 2011 Jun;63(6):1759; author reply 1760   [PMID:  21425126 ]
Arthritis Rheum. 2011 Jan;63(1):19-22   [PMID:  20954183 ]
Erratum In:
Arthritis Rheum. 2011 May;63(5):1468

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