Impact of baseline fluorescent antinuclear antibody positivity on the clinical outcome of patients with primary autoimmune hemolytic anemia

Abstract Introduction Autoimmune haemolytic anaemia (AIHA) is an autoimmune disorder that can present in primary or secondary forms. The literature looking at impact of baseline fluorescent antinuclear antibody (FANA) positivity on outcomes of AIHA patients is infrequent. Objective To study the impact of baseline FANA positivity in patients with primary AIHA. Method A prospective cohort study involving 29 consecutive primary AIHA patients presenting to the Haematology department from 2013 to 2015 was analysed. After recording baseline investigations including fluorescent ANA, all patients were treated as per the standard therapeutic protocols. Clinical remission, disease free survival, relapse, mortality were compared between the FANA positive and FANA Negative AIHA groups. Results Baseline FANA positivity was found in 17 patients (58.62%). Both the groups were comparable in terms of age, sex, Hemoglobin, LDH at presentation, number of lines of treatment needed and duration of follow up. Evan's syndrome was seen in six of FANA positive patients which was statistically significant (0 v/s 6, p= 0.023). FANA positive patients had significantly higher rates of relapse per patient month follow up (1.22 v/s 3.57, p= 0.023) and lower rates of complete response (83.33% v/s 35.29%, p= 0.0118) and relapse free survival at five years. Morbidity and mortality were numerically higher in FANA positive patients. Conclusion Baseline FANA positivity among AIHA patients was found to be associated with lower complete response rates and higher relapse rates with possible higher rates of morbidity. Presence of FANA will give us prognostic value and help us in deciding the treatment options.

Clinical observation of early-onset antinuclear antibody-positive juvenile idiopathic arthritis / 中华微生物学和免疫学杂志

Objective:To investigate the clinical features, treatment and follow-up of children with early-onset antinuclear antibody (ANA)-positive juvenile idiopathic arthritis (JIA).Methods:Eighty-six oligoarticular JIA patients with early-onset arthritis (≤6 years old) admitted to the Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2017 to December 2019 were included in this study. According to ANA titer, these patients were divided into two groups: ANA-positive group (44 cases) and ANA-negative group (42 cases). Clinical data including demographic data, clinical features, laboratory testing results, treatment and follow-up data were statistically analyzed.Results:The ratio of male to female was 7∶37 in the ANA-positive group and 15∶27 in the ANA-negative group and there was significant difference between the two groups ( P=0.035). The proportions of patients with increased C-reactive protein and erythrocyte sedimentation rate were higher in the ANA-positive group than in the ANA-negative group [18.18% (8/44) vs 16.67% (7/42) and 29.55% (13/44) vs 19.05% (8/42), both P>0.05]. The most commonly involved joints in the ANA-positive group were knee (95.45%, 42/44), ankle (20.45%, 9/44) and wrist (18.18%, 8/44), and unilateral asymmetric joint involvement accounted for 81.8% (36/44). In the ANA-negative group, the involved joints were knee (85.71%, 36/42), ankle (14.29%, 6/42), wrist (14.29%, 6/42) and hip (11.90%, 5/42), and 27 out of the 42 cases (64.29%) had unilateral asymmetric joint involvement. There was no significant difference in the above indexes between the two groups (all P>0.05). There were seven cases (15.91%) with uveitis in the ANA-positive group and two cases (4.76%) in the ANA-negative group, and the difference between the two groups was significant ( P=0.045). Before treatment, the ANA-positive group had a significantly higher disease activity score (JADAS27) than the ANA-negative group (14.43±2.87 vs 12.09±3.32, P=0.002). After treatment, the JADAS27 score in both groups decreased (both P<0.05). After six months of treatment, the two groups had similar clinical remission rates [70.45% (31/44) vs 76.19% (32/42), P>0.05]. Conclusions:Early-onset ANA-positive JIA was more common in female children, and asymmetric knee joint involvement was the most common clinical manifestation. The incidence of ophthalmic complications was high, and ophthalmological examination should be performed more frequently during follow-up. The prognosis of early-onset ANA-positive JIA was good with early treatment. Positive ANA was not a risk factor for poor prognosis.

PREVALENCE OF ANTI-NUCLEAR ANTIBODY IN THE INDIAN POPULATION: A TERTIARY REFERENCE LABORATORY STUDY

Background: Autoimmune diseases are known to be the third leading cause of fatality and morbidity amongst the population of industrialized world. They account for 3-9% of health burden in general people, but information regarding prevalence of autoantibodies and autoimmune diseases in developing nations is scarce. To study the prevalence of Anti-nuclear antibodies, Aim: the total number and distribution of different tests used in the diagnosis of anti-nuclear antibody amongst Indian population, and correlate the findings from these tests with the clinical characteristics of the patients. Retrospective data was evaluated from a Global Reference Method: Diagnostic Laboratory in Mumbai, for a period of 6 years. This included a total of 285095 cases tested for ANA. ANA-IFA and ANA-ELISA were the screening tests used while ANA-ELISA Profile and ANA Blot were the confirmatory tests. ANA by IFA was the most preferred Results: screening test (88.73%) and ANA by Blot was the most preferred Confirmatory test (67.13%) based on their sensitivity and positive predictive value respectively. ANA-IFA showed positivity of 36.48% and ANA by ELISA test had positivity of 11.46%. In confirmatory testing, ANA Blot showed a positivity of 31.90% and ELISA Profile had 23.36% positivity. Females showed significantly higher positivity for both the screening test and Confirmatory tests than males (p<0.001). Screening by ANA IFA and Confirmatory by Conclusion: ANA Blot was the most preferred tests in our study population. These tests were found to be better for diagnosis, sub-syndrome categorization, prognosis, clinical follow-up and therapeutic strategies in various autoimmune disorders.

Analysis of clinical features and prognosis of acute severe autoimmune hepatitis / 中华肝脏病杂志

Objective: To analyze the clinical features and prognosis of acute severe autoimmune hepatitis (AIH). Methods: A retrospective analysis of the clinical data of patients with acute severe AIH admitted to our hospital from 2008 to 2019 was divided into acute AIH (A-AIH) and chronic acute AIH (AC-AIH) according to the presence or absence of liver diseases. Patients' general condition, liver biochemistry, immunology, histological features of liver, hormonal therapies prognosis and related factors were analyzed. Results: A total of 41 cases [39 females, age (54.24 ± 10.55) years] were collected. Alanine aminotransferase (ALT) and total bilirubin (TBil) were significantly increased, and the international normalized ratio (INR) was > 1.5. Acute lobular inflammation was the feature of acute and severe AIH in the histology of liver. The serum IgG level was (28.36 ± 8.35) g / L. The positive rate of antinuclear antibody (ANA) and anti-smooth muscle antibody (ASMA) was 82.9%, and 17.1%, respectively. Over 70% of acute severe AIHs were AC-AIH. The duration of onset of AC-AIH was > 8 weeks, while most A-AIHs < 8 weeks, and the differences between the two groups were statistically significant (P = 0.001). The mortality rate within 30 days after hormonal treatment was 19.5%. There were statistically significant differences in TBil, Model for End-Stage Liver Disease (MELD) score and leukocyte count between the death and survival group. Conclusion: The mortality rate in acute severe AIH is high, and most of them have the basis of chronic liver disease. Serum IgG level, autoantibodies and acute lobular inflammation are important factors for diagnosis. The prognosis of hormonal therapy is related to the patients' condition and course of disease.

The clinical characteristics of nuclear dense fine speckled pattern in 95 289 patients / 中华内科杂志

To investigate the distribution and clinical significance of nuclear dense fine speckled (DFS) pattern in various diseases. A total of 95 289 patients who received DFS tests at Peking Union Medical College Hospital from January 2019 to December 2020 were included in this study. The results of indirect immunofluorescence assay (IIF) for detection of antinuclear antibody (ANA) were evaluated. The positive rates of ANA and DFS were 39.60% (37 733/95 289) and 1.19% (1 139/95 289) respectively. The positive rate of DFS in ANA-positive patients was 3.02% (1 139/37 733). DFS and ANA positivity were significantly different among different age groups rather than gender. The positivity rate of DFS reached the peak (55.57%, 633/1 139) in young patients between 21-40 years, while positive ANA with negative DFS was mainly observed in patients between 41-60 years (37.26%, 13 636/36 594). Additionally, single ANA-positivity were mainly detected in rheumatology department (59.23%, 18 402/31 066), whereas positive DFS was more common in obstetrics and gynecology department (3.08%, 49/1 593). There were 82.88% (944/1 139) patients with positive DFS diagnosed with non-autoimmune disease (non-AID), and 19.49%(222/1 139) with dermatosis. Positive DFS with higher titer (≥1∶320) was detected more frequently in autoimmune disease (AID) patients (5.13%, 10/195) than in non-AID patients (1.69%, 16/944) ( P<0.05). The DFS pattern is rare in ANA positive patients, which is mainly observed in women between 21-49 years. High titer of DFS is prevalent in AID patients, but positive DFS is detected more in non-AID patients, especially those with dermatosis.

Alopecia areata y vitamina D sérica en pacientes iraquíes: un estudio de casos y controles / Alopecia Areata And Serum Vitamin D in Iraqi Patients: a case-control study

Background: Alopecia areata (AA) is a typical hair issue, which may have obliterating mental and social outcomes and is portrayed by the nearness of nonscarring alopecia. Objective: This examination has targets to assess the serum nutrient D levels , with AA; contrast the outcome and clearly sound control; and confirm relationship between AA types and serum nutrient D levels. Patients Also Methods: the examine might have been led clinched alongside Tikrit educating healing facility throughout those time starting with June 2019 of the limit for January 2020. Irrefutably the quantity of subjects associated with the assessment was ninety individuals isolated in two social events; the patients bundle were forty five the people who whimper of AA while the resulting gathering including a forty five age and sex-made solid volunteers were picked as a benchmark gathering. The degree and movement of the alopecia were noted and the patients were meticulously broke down for signs of various ailments. Research center assessments were led to patients and also to those control population, these included serum vitamin D levels were measured as 25-hydroxyvitamin D {25(OH)D} using a chemiluminescence microparticle immunoassay. Blood models were gotten starting with patients and control subjects after totally taught consent was gotten. Results : An essential complexity may have been found for serum 25-OH Vit D levels between patients other than controls. Vitamin D sufficiency were more common in controls than in patients. Serum Vitamin D was deficient in both cases and controls group; but, the deficiency was significantly more throughout AA group (35. 6%) compared to the handle group (11. 1%). Among the list patients gathering, levels associated with nutrient D were totally higher in guys in contrast with females. Conclusions: AA might be related with nutrient D deficiency as mean degrees of nutrient D of patients were seen as fundamentally lower than typical sound controls.

Clinical and laboratory characteristics of rheumatoid arthritis with positive antinuclear antibody / 北京大学学报(医学版)

OBJECTIVE@#To analyse the clinical and laboratory characteristics of antinuclear antibody (ANA) positive rheumatoid arthritis (RA) patients.@*METHODS@#The clinical and laboratory data of 428 RA cases from Department of of Rheumatology and Immunology Peking University Third Hospital from Jan 2013 to Dec 2018 were collected and used to analyse characters between ANA positive group and ANA negative group. T test was used for the quantitative data in accordance with normal distribution. Wilcoxon rank sum test was used for the quantitative data of non normal distribution. The qualitative data were analyzed by chi square test. But while 1≤theoretical frequency < 5, chi square test of corrected four grid table was used. And Fisher exact probability method was used when theoretical frequency < 1.@*RESULTS@#The number of ANA positive group was 231 (54%). The female rate was obviously higher in ANA positive group (82.7% vs. 63.5%, χ2=20.355, P < 0.01). The rate of metatarsophalangeal joints (MTPJs) involvement was lower in ANA positive group (22.1%) than in ANA negative group (33.0) (χ2=6.414, P < 0.05). The incidence of secondary Sjögren's syndrome (sSS) was much higher in ANA positive group(19.5% vs. 4.1%, χ2=23.300, P < 0.01). The positivity of rheumatoid factor (RF), as well as the positivity of anti-cyclic citrullinated peptide(CCP) antibody was much higher in ANA positive group (77.1% vs. 53.8%, χ2=25.743, P < 0.01, 74.9% vs. 59.4%, χ2=11.694, P < 0.01, respectively). The levels of immunoglobulin G (IgG) and immunoglobulin M (IgM) of ANA positive group were higher [(15.1±5.1) g/L vs. (13.8±5.3) g/L, t=2.359, P < 0.05, 1.25 (0.92) g/L vs. 1.05 (0.65) g/L, Z=-3.449, P < 0.01, respectively]. But the levels of hemoglobin (Hb) and platelet (PLT) was lower in ANA positive group[(109.64±17.98) vs. (114.47±18.48) g/L, t=-2.734, P < 0.01; (266.4×109±104.6×109) vs. (295.9×109±100.1×109) /L, t=-2.970, P < 0.01, respectively].@*CONCLUSION@#The incidence of sSS was obviously higher in ANA positive group than in ANA negative group. Serum IgG of ANA positive group was higher, but Hb and PLT were lower.

The Role of Autoantibodies in Idiopathic Inflammatory Myopathies

Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of autoimmune muscle diseases with systemic involvement. Patients with IIM present with varying degrees of muscle disease, cutaneous manifestations, and internal organ involvement. The diagnosis and classification of IIM is based primarily on the classification system composed of clinical features, laboratory value and muscle biopsy. In addition, the identification and characterization of myositis-related autoantibodies can help diagnosis and classification. Recently, many studies have also demonstrated that the physician can define the clinical syndromes, establish treatment strategy and predict outcomes based on the patients' myositis-specific autoantibodies (MSA) and myositis-associated antibodies (MAA) profiles. MSAs are found exclusively in IIMs and facilitate the identification of subsets of patients with relatively homogeneous clinical features. MAAs are frequently found in association with other MSA; however, they may also be detected in various connective diseases.

A Diagnostic Roadmap for Raynaud's Phenomenon / 대한내과학회지

Raynaud's phenomenon (RP) is a reversible vasospasm that is aggravated by cold or emotional stress. Before confirming RP, it is essential to consider other possible causes including compressive neuropathy, sensori-neuropathy, thyroid disease, hematologic conditions and offending drugs. RP is typically characterized by the three-step color change that turns pallor (white), cyanosis (blue), and then erythema (red) of reperfusion. Once RP is diagnosed, it is important to determine whether it is primary or secondary RP. To distinguish primary from the secondary RP, the specialized tests performing in clinical practice are antinuclear antibody (ANA) and nailfold capillary microscopy (NFC). The combination of ANA and NFC is most helpful for discriminating secondary RP due to autoimmune rheumatic disease. Thereby, normal findings of NFC in primary RP distinguished from secondary RP should be understood. Patients with primary RP usually improves with symptomatic treatment focused on lifestyle modification and patient education, but those with secondary RP should be treated together with associated disease or causes.

Analysis on the different expression of autontinuclear antibody in the patients with systemic lupus erythematosus between Uygur and Han / 国际检验医学杂志

Objective To explore the difference of serum autoantibody spectrum in patients with systemic lupus erythematosus (SLE).Methods ENA antibody in SLE patients was detected by immunoblotting,and anti nuclear antibody (ANA) was detected by indirect immunofluorescence (IIF),and the specific fluores-cence model was checked by microscope under fluorescence microscope.The results were statistically pro-cessed and evaluated.Results The positive rate of Ro-52(19.7%) and SSA (40.9%)in Han was higher than that in the Uygur,and the difference was statistically significant (7.5% and 30.0%,P<0.05).And the positive rate of perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA),proliferating cell nuclear antigen (PCNA) and histone in Han (20.0%,27.5%,42.5%,respectively) was lower than that in the Uygur (7.0%, 11.3% and 18.31%,P<0.01).There were significant differences in the expression of nucleosome and P-Prot antibody titers among different ethnic groups,the positive rate of nucleosome antibody in Uygur group (17.50%)was higher than that in Han group (11.27%,χ2=8.37,P<0.05).Compared with the Han group (18.31%),the P-Prot antibody was also increased in the Uygur group (42.50%,χ2=9.55,P<0.05).The positive rate of nucleosome antibody in Uygur patients with homogeneous positive samples was significantly higher than that in Han patients (χ2=10.43,P<0.01).Conclusion T he positive rates of anti-Ro-52,SSA,P-ANCA,PCNA and histone antibodies were different in patients with SLE,and there were significant differ-ences betweenin nucleosome and P-Prot antibody titer,which was of great significance in the diagnosis and the selection of the target for the treatment of SLE.

Diagnostic value of different detecting technologies in antinuclear antibody in autoimmune disease / 国际检验医学杂志

Objective To evaluate the diagnostic value of different detecting technologies in antinuclear an-tibody(ANA)in autoimmune diseases(AID).Methods A total of 52 cases of patients with systemic lupus er-ythematosus(SLE),97cases of patients with AID but without SLE,92 cases of patients without immune disea-ses were collected in this study.ANA was detected by enzyme-linked immunosorbent assay(ELISA),indirect immunofluorescence(IIFA)method and linear western blot method(LIA).Results Average coincidence rate between ELISA and IIFA method to detect the ANA was 78.8% in the three groups of participants.The re-sult of ANA detected by ELISA method was positively correlated with that of IIFA method(r=0.598,P<0.05).They found that patients with AID and without AID groups both existed the phenomenon of IIFA ANA+LIA ANA -,their fluorescence titers were given priority to with 1:100.Their fluorescence modes were given priority to with granularity in both AID group(67.44%)and without AID group(54.69%),there was no difference between the two groups(P>0.05),but they were significantly higher than that of other flu-orescence modes.At the same time,the study found that patients with IIFA ANA -LIA ANA+were mostly AID patients(73.3%),the ratio was higher than without AID group,among these patients,AID patients were with SSA/Ro60,SSA/Ro52,SSB/La as the main positive autoantibodies,rather than without AID patients with anti-Sm,SSA/Ro52,SSB/La,CenpB as the main positive antibodies.Conclusion It should pay attention to multi-index joint and multi-tests detection when we diagnose autoimmune diseases.

New Provisional Classification of Juvenile Idiopathic Arthritis Applying Rheumatoid Factor and Antinuclear Antibody

OBJECTIVE: Previous classification systems for juvenile idiopathic arthritis (JIA) were based on the number of joints involved and did not categorize homogenous disease entities. Therefore, JIA patients were reclassified retrospectively by applying rheumatoid factor (RF) and antinuclear antibody (ANA), which have been proven to constitute a homogenous disease entity. METHODS: The medical records of JIA patients were investigated retrospectively and reclassified into six categories using the new provisional classification. The nomenclature was based on Dr. Martini's proposal in the 23rd European Paediatric Rheumatology Congress (2016) at Genoa, Italy. New categories included systemic JIA (sJIA), RF-positive JIA (RF-JIA), early-onset ANA-positive JIA (eoANA-JIA), enthesitis/spondylitis-related JIA (ESR-JIA), “other JIA”, and “unclassified JIA”. RESULTS: Of a total of 262 JIA patients, 71 (27.1%) were reclassified as sJIA, 31 (11.8%) as RF-JIA, 22 (8.4%) as eoANA-JIA, 63 (24.0%) as ESR-JIA, 65 (24.8%) as “other JIA”, and 10 (3.8%) as “unclassified JIA”. A comparison of RF-JIA, eoANA-JIA, and ESR-JIA revealed significant differences in the gender ratio, age of disease onset, and the cumulative number and type of joints involved among the three groups. “Other JIA” comprised a significant proportion (24.8%) and warrants the need for further classification. The characteristics of the RF-positive patients were comparable to those of the anti-cyclic citrullinated peptide antibody-positive patients. The ANA positivity was lower (28.2%) than that in Western studies but showed similar clinical features. CONCLUSION: This is the first study applying RF and ANA to classify JIA without considering the joint counts. The six new categories include sJIA, RF-JIA, eoANA-JIA, ESR-JIA, “other JIA,” and “unclassified JIA”.

Analysis of peripheral blood lymphocyte subsets in patients with antinuclear antibody positive / 国际检验医学杂志

Objective To investigate the clinical application value of peripheral blood lymphocyte subsets expression levels in autoimmune disease(AID) among the patients with antinuclear antibody(ANA) positive .Methods 200 patients with ANA positive and 196 patients with ANA negative were selected as the experimental group and control group respectively .The experimental group adopted indirect immunofluorescence assay (IFA) and immunoblotting assay(LIA) for detecting ANA ,moreover divided into the IFA group and LIA group according to the detection results .Meanwhile the flow cytometry was adopted to detect peripheral blood T lymphocytes ,helper T lymphocytes ,cytotoxic T lymphocyte ,NK lymphocytes and B lymphocytes absolute values of each group .The detection results were statistically analyzed .Results Helper T lymphocytes ,NK lymphocytes and B lymphocytes absolute values in the experimental group were significantly lower than those in the control group ,the differences were statistically significant(P＜0 .01);in the experimental group ,helper T lymphocytes and NK lymphocytes absolute values in the IIF group were significantly lower than those in the LIA group ,the differences were statistically significant (P＜0 .01) .Conclusion Peripheral blood lymphocytes subsets can serve as the important detection indicators during the diagnosis and treatment process of AID .

The clinical significance of rheumatoid arthritis merger antinuclear antibody positive / 国际检验医学杂志

Objective To understand the fluorescence pattern of antinuclear antibody(ANA)and the distribution of target anti-gen and ANA′s impact on rheumatoid arthritis(RA)RA.Methods The data of rheumatoid factor(RF)and anti-cyclic citrullinated peptide antibodies(anti-CCP antibodies)and ANA of 860 RA patients during 2014-2015 were collected and divided into 2 groups according to the ANA levels.The differences of RF and anti-CCP antibodies level between 2 groups were analyzed.Analyzed the fluorescence pattern of RA merger ANA and the distribution of target antigen by statistical.Results Of the 860 RA patients,the positive rate of ANA was 37.6%,the major fluorescence pattern of RA merger ANA was speckled pattern,anti SSA positive rate was 21.7%.The RF and anti-CCP antibodies level had statistical difference between ANA positive group and ANA negative group (P <0.05).Conclusion RA merger ANA positive can show different fluorescence patterns and target antigen,the speckled pattern and anti-SSA positive are the main pattern.The severity of arthritis symptoms and the degree of bone destruction between ANA positive group and ANA negative group were difference.Anti-ANA positive has a certain promoting effect on the progression of RA disease.

Performance of an Automated Fluorescence Antinuclear Antibody Image Analyzer

BACKGROUND: The gold standard for antinuclear antibody (ANA) screening is the indirect immunofluorescence (IIF) assay with human epithelial cells (HEp-2). However, a number of substantial disadvantages of manual IIF assays have highlighted the need for the automation and standardization of fluorescent ANA (FANA) testing. We evaluated the performance of EUROPattern Suite (Euroimmun AG, Germany), an automated FANA image analyzer, with regard to ANA detection and pattern recognition compared with conventional manual interpretation using the fluorescence microscopic IIF assay. METHODS: A total of 104 samples including 70 ANA-positive sera and 34 ANA-negative sera collected from September to October 2015 were included. The sensitivity, specificity, and pattern recognition function were evaluated to determine the performance of EUROPattern Suite compared with the manual IIF assay results. RESULTS: The sensitivity and specificity of EUROPattern Suite for ANA detection were 94.3% and 94.1%, respectively. The concordance rate between the two methods was 94.2%. For pattern recognition, 45.7% of the samples were assigned identical ANA patterns including simple and mixed. When major pattern matching was considered, 83.7% (41/49) and 95.2% (20/21) of the samples with simple and mixed patterns, respectively, showed concordant results between the two methods. CONCLUSIONS: EUROPattern Suite, an automated FANA image analyzer, provides a viable option for distinguishing between positive and negative results, although the ability to assign specific patterns is insufficient to replace manual microscopic interpretation. This automated system may increase efficiency in laboratories, in which a large number of samples need to be processed.

Value of detections of antinuclear antibody combined with anti-cardiolipin antibody, anti-sperm antibody and anti-β2-glycoprotein I antibody in female infertility / 国际检验医学杂志

Objective To investigate the value of detections of anti‐nuclear antibody (ANA) combined with anti‐cardiolipin anti‐body (ACA) ,anti‐sperm antibody (AsAb) and anti‐beta 2 glycoprotein I (β2 GPI) antibody in the diagnosis of female infertility dis‐ease .Methods A total of 187 female cases of infertility (infertility group) were detected serum ANA and AsAb by the indirect im‐munofluorescence assay ,and ACA andβ2 GPI antibody by the enzyme linked immunosorbent assay (ELISA) .ANA ,ACA ,AsAb andβ2 GPI antibody also were detected in 80 females cases of normal fertility (normal group) .Results Among 187 cases of female infer‐tility ,ANA positive rate was 18 .1% (34/187) and which in the normal group was 2 .5% (2/80) .The ACA positive rate was 22 .3%(43/187) in the infertility group and 5 .0% (4/80) in the normal group ;the AsAb positive rate was 18 .7% (35/187) in the infertil‐ity group and 3 .8% (3/80) in the normal group ;theβ2 GPI positive rate was 20 .3% (38/187) in the infertility group and 3 .8% (3/80) in the normal group;the differences between the two groups had statistical significance (P<0 .05) .Conclusion Infertility is closely correlated with the in vivo existence of ANA ,ACA ,AsAb andβ2 GPI antibody ,the joint detection is conducive to find the e‐tiology of infertility and improve the clinical diagnosis rate .

Expression of serum AQP4-Ab and the significance in patients with optic neuritis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the serum antibody of aquaporin 4 ( AQP4 - Ab ) in positive expression rate and the significance in patients with neuritis. ●METHODS: A total of 98 cases ( 128 eyes ) of patients with optic neuritis were studied to detect the patient′s serum AQP4-Ab positive rate of antinuclear antibodies ( ANAs) from Jan. 2012 to Dec. 2015 in ophthalmology center of our hospital. According to the expression of AQP4 - Ab group, the best corrected visual acuity between the two groups, peripapillary nerve fiber layer thickness (pRNFL), the volume of the macula, macular RNFL ( mRNFL ) , macular core layer volume ( mlNL ) measurement were compared. ●RESULTS:Ninety-eight patients (128 eyes) with optic neuritis cases diagnosed through examination revealed AQP4-Ab positive in 22 patients ( 22%) , negative in 76 patients ( 78%) , ANAs positive in 21 patients ( 21%) , negative 77 patients ( 79%) . Optic neuritis patients with serum AQP4 - Ab positive rate and ANAs positive significant correlation ( r = 0. 707, P 0. 05). After inspection found pRNFL, macular volume measured value AQP4 - Ab positive patients were significantly less than the negative patients, the differences were statistically significant (P0. 05). ●CONCLUSION:AQP4-Ab and ANAs expression in optic neuritis patients is a significant correlation. AQP4-Ab positive patients with optic neuritis pRNFL thinning of macular volume are decreased compared with negative patients.

The changes of autoantibodies in hepatitis B patients and its clinical significance / 中国基层医药

Objective To investigate the changes of autoantibodies in hepatitis B disease and its clinical sig-nificance.Methods 418 cases of hepatitis B patients were selected as hepatitis B group.At the same time,148 hos-pitalized patients in our hospital with autoimmune hepatitis( AIH) were chosen as AIH group.And 100 healthy people with physical examination were selected as control group at the same time .The antinuclear antibodies , anti -smooth muscle antibody( SMA) and anti-kidney microsomal antibodies and other autoantibodies of the three groups were detected and analyzed statistically.Results ANA-positive rate of hepatitis B group was 22.73%,ANA titer was mainly 1:100,only two cases of liver cirrhosis titers were 1:320,ANA karyotype was mainly homogenous,only four cases belonged speckled pattern;ANA positive rate of AIH patients was 60.14%,ANA titer was mainly 1:320,or even 1:1 000, primarily as a spot -type karyotype, nucleolar and centromere type.Differences between the two groups were statistically significant (P<0.05).The positive rates of hepatitis B,chronic hepatitis,severe hepatitis B and hepatitis B patients with cirrhosis ANA were significantly higher than in patients with acute hepatitis B,the differ-ences were statistically significant (χ2 =12.172,12.560,28.123,all P<0.05).Compared with AIH group,the posi-tive rate of SMA and LKM in patients with hepatitis decreased 51.98%,32.22%,respectively,the differences were statistically significant (χ2 =196.843,107.357,all P<0.05).The positive rate of hepatitis B level ANA ( +) patients of ALT and AST,HBV DNA was significantly higher than ANA (-) group.The level of hepatitis B patients ALT and AST,HBV DNA positive group were significantly higher than AIH.Differences were statistically significant (all P<0.05).Conclusion Autoantibody detection helps to study autoimmune etiology and pathogenesis of great importance for patients with hepatitis B and cirrhosis,but the reaction involved in the pathogenesis of autoimmune hepatitis level research still needs to be deeper.

Combination therapy of cyclosporine and prednisolone in a dog with systemic lupus erythematosus

An 11-year-old, spayed female poodle presented with fever and shifting lameness. Physical examination revealed hyperthermia (40.6℃), and proteinuria was detected upon urinalysis. Increased neutrophils (83%) and decreased viscosity were revealed upon synovial fluid analysis. Serum antinuclear antibody was positive at 1 : 80. Based on these findings, the dog was diagnosed with systemic lupus erythematosus. Immunosuppressive therapy was initiated with prednisolone and cyclosporine, and the condition was markedly improved after the treatments. This case report describes the clinical and laboratory findings, imaging characteristics and successful outcomes after prednisolone plus cyclosporine therapy in a canine systemic lupus erythematosus case.

Clinical significance of enzyme linked immunosorbent assay and indirect immunofluorescence for detection of antinuclear antibody / 国际检验医学杂志

Objective To compare the value of ELISA and indirect immunofluorescence (IIF)method in diagnosis for autoim-mune diseases.Methods A total of 33 patients in systemic lupus erythematosus(SLE)group,59 patients in other autoimmune dis-eases group,43 patients in non-autoimmune disease group,20 people accepted physical examination in control group.The antinuclear antibody (ANA)in each group were detected by two methods and analyzed.Results The high titer ANA detected by ELISA and IIF in SLE group and other autoimmune diseases group were (2.621±1.700),(2.248±1.781);(2.71 5±0.730),(2.544±0.59). The titer ANA detected by ELISA in non-autoimmune disease group was (1.034±1.050),which was lower than(2.253 ±0.691) detected by IIF.Conclusion ELSA might improve the detection effects of ANA antibody.