ABSTRACT
Objective:To analyze the differences of the clinical characteristics and laboratory indexes in children with positive dense fine spot (DFS) type anti-nuclear antibody, and thereby to explore the value of positive DFS in the diagnosis of immunological diseases.Methods:Among 9 613 cases who were routinely tested for antinuclear antibody (ANA) from August 2017 to February 2020, there were 197 cases with DFS positive, who were subjected to a retrospective analysis.These patients were divided into the autoimmune diseases (AID) group (39 cases) and the non-AID group (158 cases) according to clinical diagnosis.Healthy children in the same physical examination were used as healthy control group (40 cases). T test was applied to analyze the differences of humoral immunity markers between AID and non-AID groups.What′s more, DFS positive patients in different clinical departments, initial symptom and the part of body were further compared. Results:Among 9 613 children tested for autoantibodies, 2 654 (27.61%) were ANA positive, with the highest detection rate of the spotted type and 197 DFS positive cases, accoun-ting for 7.42% of ANA positive children; 97 DFS positive male patients accounted for 8.20% (97/1 183 case) of ANA positive male patients, 100 DFS positive female patients accounted for 6.80% (100/1 471 cases) of ANA positive female patients, and there was no significant difference in the positive rate.The departments with high positive ANA detection included the nephrology department (27.88%) and the rheumatology department (24.83%). The departments with a higher ANA positive rate in DFS positive children included the gastroenterology department (13.25%) and the infectious department (11.76%). Among the children with DFS antibody positive, 39 cases had AID, among which 38 cases had organ-specific AID, and juvenile idiopathic arthritis (JIA) had the highest detection rate in 13 cases.The diseases with a high DFS positive rate in 158 non-AID cases included allergic purpura (46 cases). Serum immunoglobulin (IgG) level in the AID group was significantly lower than this in the non-AID group, serum IgM and C 4 levels in AID children were significantly lower than those in the non-AID group and healthy control group, and the serum IgA level of DFS positive group was significantly higher than that of children in the healthy control group.All children with DFS antibody positive had no specific autoantibodies. Conclusions:DFS antibody positive is important for the diagnosis of systemic AID in children.The combined detection with the DFS, other autoimmunity antibody index, humoral immune function index contributes to the early differential diagnosis of autoimmune diseases in children.
ABSTRACT
Objective To explore the influence of prozone effect on anti-nuclear antibodies (ANA) testing by indirect immunofluorescence assay (IIFA).Methods The samples with high titer of ANA (≥1∶1 000) were selected from 880fresh serum samples, and were subsequently diluted in 1∶100, 1∶1 000and 1∶10 000ratio.Prozone effect was defined as fluorescence intensity from 1∶1 000dilution was stronger than that from1∶100dilution.The samples with prozone effect were determined manually or by Sprinter XL and EUROPattern.The samples with prozone effect were further characterized by combinations of fluorescence patterns, fluorescence intensities and autoantibody specificities.Results A total of 880samples were tested.Importantly, 34samples displayed prozone effect (3.86％in total and 29.57％in samples with ANA≥1∶1 000).Interestingly, prozone effect was identified by manual detection as well as by Sprinter XL with similar fluorescence patterns and fluorescence intensities.Notably, EUROPattern can only select the central area for identification.Among all samples with prozone effect, 74.42％samples exhibited fluorescence intensities of≥1∶10 000.Speckled pattern was the most prevalent fluorescence patterns in samples with prozone effect (46.51％).In addition, anti-RNP antibodies (62.79％) were the most popular autoantibodies in samples with prozone effect, followed by anti-dsDNA antibodies (51.16％) and anti-SSA antibodies (51.16％).Conclusion Prozone effect was present in ANA testing, especially in samples with high titers, resulting in underestimating the titers.The study highlighted that special attention should be paid to the prozone effect in clinical practice.
ABSTRACT
OBJECTIVE: To explore the detection of autoantibodies in serum of patients with coal workers' pneumoconiosis( CWP).METHODS: Eight hundred and three cases of stage Ⅰ CWP patients were selected as study subjects by random sampling method.Anti-nuclear antibody and anti-neutrophil cytoplasmic antibody( ANCA) in serum were detected by indirect immunofluorescence assay; myeloperoxidased efficiency( MPO) antibody,anti-mitochondrial M2 antibody( AMA-M2) and anti-cyclic citrullinated peptide( CCP) antibody were detected by enzyme-linked immunosorbent assay;rheumatoid factor( RF) was detected by enhanced immunoturbidimetry of latexa.Group analysis was conducted according to age,lung function,length of dust exposure and the nature of dust exposure collection.RESULTS: In the serum of 803 CWP patients,the positive rate of anti-nuclear antibody,AMA-M2,RF,anti-CCP antibody,ANCA and MPO antibody were 9.7%,7.5%,7.3%,4.0%,2.6% and 0.8% respectively; the karyotype distribution of 78 cases of anti-nuclear antibody positive specimens was spotted( 43.6%), cytoplasmic( 20.5%), homogenous( 7.7%) and nucleolus( 5.1%),with a titer of 1:100.The positive rate of anti-nuclear antibody in the > 70.0 years group was higher than that of ≤60.0 and ≤70.0 years group( P < 0.017); the positive rate of anti-nuclear antibody in the abnormal lung function group was lower than that of the normal group( P < 0.01); the positive rate of anti-CCP antibody in the dust exposure length > 30.0 years group was higher than that of ≤30.0 years group( P < 0.017); the positive rate of anti-CCP antibody in silica-exposed group was lower than that in the coal-exposed group( P < 0.01).CONCLUSION: The positive rate of antinuclear antibody,AMA-M2,RF and anti-CCP antibody in CWP patients were high.The positive rate of anti-nuclear antibody is associated with age and lung function.The positive rate of anti-CCP antibody is related to the duration and nature of dust exposure.
ABSTRACT
Objective To detect serum antinuclear antibody (ANA) with enzyme-linked immunosorbent (ELISA) and linear immunoblot technique (LIA) and to evaluate and compare the performance of two methods in auxiliary diagnosis of systemic lupus erythematosus (SLE). Methods ANA detected by both ELISA and LIA of 597 cases were collected in the last two years. The results were retrospective analyzed. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and the consistency of the two methods were compared and analyzed. Results The sensitivity of ELISA and LIA was 79.3% and 86.6% respectively for SLE patients; specificity 81.7% and 77.3%; accuracy 81.4% and 78.6%, positive predictive value 40.9%, and 37.8%;negative predictive value 96.1% and 97.3% respectively. No significant difference was found between the two methods (P > 0.05). The results showed that the coincidence rate was 81.4%, and the Kappa test 0.55. The Kappa test of the two methods in SLE group was 0.403. Conclusion No statistical significance is found in the comparison of ELISA method and LIA method to detect ANA for the diagnosis of SLE and the combination of two kinds of detection method has important application value.
ABSTRACT
Objective To investigate the clinical value of anti-nuclear antibody(ANA) and anti-nuclear antibody spectrum(ANAs) detection.Methods A total of 2 325 patients with or suspected with autoimmune diseases(AID) were enrolled and detected for ANA and ANAs by using indirect immunofluorescence assay(IIF) and linear immunoblot assay(LIA) respectively.All detected results were analyzed.Results Among 2 325 patients,896 cases(38.54%) were positive with ANA,with positive rate of 45.46% in female patients,which was higher than the 18.46% of male patients(P<0.05),and the common fluorescence patterns were nuclear particle pattern,nuclear homogeneous pattern and the nucleolus pattern.816 cases(35.10%) were positive with ANAs,and the positive rates of anti-Sjogren's syndrome(SS)-B antibody,anti Ro-52 antibody and anti SS-A antibody were relatively higher.The consistency rate of the two methods was 91.66%.Conclusion ANA and ANAs detection could be with certain correlation,but might be not completely consistent,detection could improve the detection rate and reduce the missed detection rate.
ABSTRACT
Autofluorescence exhibited by tissues often interferes with immunofluorescence. Using imaging and spectral analysis, we observed remarkable reduction of autofluorescence of formalin fixed paraffin embedded tissues irradiated with light prior to incubation with immunofluorescent dyes. The technique of photobleaching offers significant improvement in the quality and specificity of immunofluorescence. This has the potential for better techniques for disease diagnosis.
Subject(s)
Antibodies, Antinuclear/diagnosis , Fluorescent Antibody Technique/methods , Lung/cytology , /methods , Photobleaching , Spectrometry, Fluorescence/methodsABSTRACT
A 15-year-old female patient presented with orthostatic erythema in the limbs for half a year. Skin examination revealed that diffuse reticular erythema appeared in the limbs after standing with her arms hanging down for 30 seconds, while the erythema disappeared and skin color returned to normal after raising her arms or lying flat for 30 seconds. The rash in the limbs was reproduced by inflating a sphygmomanometer cuff to 60 mmHg for 2 minutes with the limbs in the horizontal position. Antinuclear antibodies were positive at a titer of 1 ∶1 000. Histopathological examination showed dilated small vessels in the superficial dermis without obvious inflammatory cell infiltration. The patient was diagnosed with gravitational erythema.
ABSTRACT
PURPOSE: To report two patients with positive ice tests who had diplopia and blepharoptosis caused by something other than ocular myasthenia gravis. CASE SUMMARY: A 35-year-old female presented with a one-week history of inability to adduct the left eye and left blepharoptosis. Although the ice test was positive, serum anti-acetylcholine receptor binding antibody and the repetitive nerve stimulation test were negative. Brain angiography showed an aneurysm of the left posterior communicating artery, leading to the diagnosis of left pupil-sparing oculomotor nerve palsy. A 25-year-old female presented with an 8-month history of intermittent horizontal diplopia and blepharoptosis in the right eye. The ice test was positive, however serum anti-acetylcholine receptor binding antibody and the repetitive nerve stimulation test were negative. Anti-nuclear antibody was positive (titer 1:160). CONCLUSIONS: The ice test is a useful screening test for myasthenia gravis. However, a series of differential diagnoses including blepharoptosis and ocular motility disorder should be considered because these conditions also show a positive result in the ice test.
Subject(s)
Adult , Female , Humans , Aneurysm , Angiography , Arteries , Blepharoptosis , Brain , Diagnosis , Diagnosis, Differential , Diplopia , Ice , Mass Screening , Myasthenia Gravis , Ocular Motility Disorders , Oculomotor Nerve DiseasesABSTRACT
Objective To investigate the correlation between the anti-nuclear antibody(ANA)pattern and the specific ANA spectrum.Methods 974 cases of detected ANA results in our hospital were analyzed retrospectively.The ANA pattern was detec-ted by the indirect immunofluorescence(IIF)and the specific ANA spectrum was tested by the line immunoassay(LIA).199 cases of both simultaneous positive results by IIF and LIA were analyzed and the correlation between ANA patterns and specific ANA spectrum was analyzed.Results Among 974 cases of specimen,249 cases(25.6%)were positive by IIF and 237 cases(24.3%) were positive by LIA,the difference in the positive rate between IIF and LIA had no statistical significance(P >0.05 ).287 cases (29.5%)were positive by single IIF or LIA or both IIF and LIA,which was higher than the positive rate by single IIF or LIA (P <0.05).Among 249 cases of positive by IIF,119 cases(79.9%)were positive by LIA,among 725 cases of negative by IIF,687 (94.8%)cases were negative by LIA.The anti-Ro-52 antibody was frequently detected in the nuclear speckled pattern,and the an-ti-M2 antibody was detected more frequently in the cytoplasmic speckled pattern,anti-dsDNA antibody and anti-nucleosome anti-body were more frequently detected in the nuclear homogeneous pattern,anti-centromere antibody was more frequently detected in the centromere pattern and anti-PM-Scl antibody was more frequently detected in the nucleolus pattern.Conclusion The ANA de-tection has better correlation between IIF and LIA,but also has certain difference.Their combined detection can reduce the missed detection rate and has the important significance to the diagnosis,disease condition monitoring and prognosis judgment of autoim-mune diseases.
ABSTRACT
BACKGROUND: Dense fine speckled (DFS) pattern in antinuclear antibody (ANA) test using indirect immunofluorescence method became to be known recently and it is detected in patients with various chronic inflammatory diseases as well as in healthy individuals. We investigated the relation between DFS pattern and various diseases. METHODS: ANA tests by indirect immunofluorescence method using HEp-2 cell line slide (Kallestad; Bio-Rad, USA) were performed in 2,654 patients for screening of systemic autoimmune diseases. The frequencies of ANA and DFS positivity were analyzed according to sex, age, clinical department and disease. RESULTS: ANA was positive in 13.3% (352/2,654) of the total patients, and the frequency of DFS pattern was observed in 3.8% (101/2,654) of the total patients and in 28.7% (101/352) of the patients with ANA positivity. Higher frequency of DFS positivity was observed in patients referred from Departments of Rheumatology and Nephrology, but there was no difference in the frequencies of DFS positivity among the patients with ANA positivity. The frequency of DFS pattern was higher in seborrheic dermatitis (14.3%), herpes zoster (11.1%), rheumatoid arthritis (16.9%), systemic lupus erythematosus (15.4%) and Sjogren syndrome (14.3%). CONCLUSIONS: The DFS pattern is a frequent finding (about 28% of ANA positivity) in ANA test using indirect immunofluorescence method. Relatively high frequency of DFS pattern was observed in autoimmune diseases, contrary to the previous observations that DFS pattern is not related with autoimmune diseases. Further studies including the confirmation tests of anti-DFS70 are needed for the identification of relation between DFS pattern and particular diseases.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Adaptor Proteins, Signal Transducing/immunology , Antibodies, Antinuclear/blood , Arthritis, Rheumatoid/immunology , Fluorescent Antibody Technique, Indirect/methods , Retrospective Studies , Transcription Factors/immunologyABSTRACT
BACKGROUND/AIMS: Exclusion of liver disease from other causes such as autoimmune hepatitis is necessary for diagnosis of nonalcoholic fatty liver disease (NAFLD). However, there has been no study on the prevalence and significance of autoantibodies in the patients with clinically suspected NAFLD in Korea, where hepatitis B is endemic and autoimmune hepatitis is relatively uncommon. METHODS: We prospectively tested for anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA), and anti-mitochondrial antibody (AMA) in 135 serially enrolled patients with suspected NAFLD. We compared the clinical characteristics and biochemical indices of the ANA-positive or ASMA-positive group with those of the autoantibody-negative group. RESULTS: Sixteen patients (11.8%) had serum autoantibodies; there was ANA in 8 patients (5.9%), ASMA in 7 (5.1%), and AMA in 2 (1.5%). Both ANA and AMA were positive in one patient. The ANA-positive or ASMA-positive group showed an older age (49.5+/-13.0 vs. 42.0+/-10.9 years, respectively, P=0.018) and higher levels of serum globulin (3.1+/-0.4 vs. 2.9+/-0.4 g/dL, respectively, P=0.037), compared with the autoantibody-negative group. Two cases with positive ANA or ASMA fulfilled the diagnostic criteria for probable autoimmune hepatitis and two cases with positive AMA were suspected as primary biliary cirrhosis. CONCLUSIONS: These findings suggest that autoantibodies could be found in some patients with suspected NAFLD in Korea, AMA-positivity or ASMA-positivity could be associated with old age and high serum globulin, and some of the autoantibody-positive cases could be diagnosed as autoimmune hepatitis or primary biliary cirrhosis. Further studies are necessary to clarify the clinical significance of autoantibody positivity in those patients.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antibodies, Antinuclear/analysis , Autoantibodies/blood , English Abstract , Fatty Liver/immunology , Muscle, Smooth/immunologyABSTRACT
Testing for antinuclear antibodies are useful in evaluation of autoimmune disorders. Anti-nuclear antibodies are detected by a variety of techniques including indirect immuno-fluorescence, enzyme immuno-fluorescence, enzyme immunocytochemistry, and ELISA. In this study, anti-n-DAN quick test was performed on 127 patients who are treated at Rheumatology Department of Bach Mai Hospital from December 1997 to February 1999. Diagnosis in each of these disorders was based on the American College of Rheumatology criteria (ACR). The results shown that, anti-n-nDNA was positive in 84.6% patients with systemic lupus erythematosus (SLE), 24.4% patients with systemic sclerosis and only 8.3% patients with rheumatoid arthritis, respectively. Anti-n-DNA quick test is simply and easy to perform but specificity and sensitivity of this method are still limited to compare with others.
Subject(s)
Antibodies, Antinuclear , Autoimmune Diseases , Diagnosis , TherapeuticsABSTRACT
Primary biliary cirrhosis (PBC) is characterized by histological findings of an immunoinflammatory destruction of small- and medium-sized bile ducts with progressive portal fibrosis, and the presence of anti-mitochondrial antibody (AMA) with a laboratory evidence of chronic cholestasis. The term "autoimmune cholangitis" (AIC) is used for a disease with the clinical and pathologic features of primary biliary cirrhosis (PBC) but with negative AMA and positive anti-nuclear antibody (ANA) tests. Eight cases of AIC and ten cases of PBC were reviewed in order to determine whether there was any difference between two diseases in clinico-pathologic aspects. All of the patients were female and the mean ages of AIC and PBC patients were 48 and 47 years, respectively. ANA test was positive in six of ten PBC paients and their mean titer was lower than that of AIC patients. IgM level was significantly higher in PBC group than in AIC group. No significant difference was found between two groups with respect to biochemical and histopathological features. Since the only consistently distinguishing features between these two conditions are the autoantibody profile (AMA vs ANA) and immunoglobulin level (IgM), these two conditions might be part of a spectrum. PBC can be considered to be the same as AMA-positive AIC or alternatively AIC to be the same as AMA-negative PBC.