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Background: Antinuclear antibody (ANA) detection is very useful in the diagnosis of systemic lupus erythematosus (SLE). Association of specific autoantibodies with the immunofluorescence pattern of ANA in SLE as noted in Western medical literature has been taken as reference all over the world. However, in developing countries like India such research or data correlating the autoantibodies and their ANA Indirect Immunofluorescence patterns is inadequate. Objective: To identify the correlation between Indirect immunofluorescence patterns of antinuclear antibody on HEp–2 cell and serum levels of anti– double stranded DNA (anti–dsDNA) in SLE patients. Material and Methods: Serum samples of 108 SLE patients who were diagnosed by ACR (American College of Rheumatology) classification criteria, attending Rheumatology OPD of a tertiary care hospital during the study period of six months were subjected for ANA testing by Indirect Immunofluorescence (IIF) on HEp–2 cell and anti–dsDNA levels by ELISA. Results: Out of 108 SLE patients who were all positive by ANA in IIF on HEp–2 cell – exhibited predominantly two fluorescent patterns such as homogeneous in 80 (74%) and speckled 28 (26%) and in those with suspected flare–up homogeneous pattern was strongly associated with anti–dsDNA (p<0.05) and speckled pattern was also predominantly associated with anti–dsDNA (p<0.05). Conclusion: In SLE patients showing either homogeneous or speckled pattern in ANA IIF with suspected flare–up had elevated anti–dsDNA levels
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Objective:To investigate the value of autoantibodies and serum levels of IgG4 and CA19-9 in the diagnosis of IgG4 associated cholangitis (IgG4-SC).Methods:Detect the serum IgG4 and CA19-9 of 41 clinical cases of IgG4-SC patients,162 clinical cases of non IgG4-SC patients and 40 healthy human serum samples by immunoassay and direct chemiluminescence methods, also detect the antinuclear antibodies (ANA),anti neutrophil antibody (ANCA),anti smooth muscle antibody (SMA) and anti mitochondrial antibody (AMA) of the above serum samples by indirect immunofluorescence and analyze the detection results.Results:①The positive rates of ANA,ANCA,SMA and AMA in patients with IgG4-SC were 41.46%,7.32%,0 and 2.44%.Among them,the positive rate of ANA was significantly different from that of the normal control group(P<0.01),and the positive rate of SMA and AMA was significantly different from that of non IgG4-SC group(P<0.01),and so as the positive rate of ANCA do with that of PSC group.②The number of serum IgG4 and CA19-9 increased samples were significantly compared with the normal control group (P<0.01);the area under the ROC curve (AUC) was 0.979 and 0.646,respectively,and P<0.05.Conclusion:The high level of serum IgG4 and CA19-9 and autoantibody detection are of great accuracy and important clinical value in the differential diagnosis of IgG4-SC.
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La aceptación y la relevancia de los autoanticuerpos se evidencia por su creciente incorporación en los criterios diagnósticos y de clasificación de las enfermedades autoinmunes. Una de las preocupaciones actuales, derivadas del uso ampliado de los autoanticuerpos, es la conservación del uso adecuado, en contraposición con el uso indiscriminado que genera un aumento de resultados falsos positivos que conducen a costosos errores en el diagnóstico, seguimiento, e incluso, tratamiento del paciente. Este artículo intenta resumir las circunstancias en que es oportuno ordenar las pruebas de autoanticuerpos, y cómo interpretarlas para preservar su utilidad clínica y refrenar los gastos de salud(AU)
The acceptance and relevance of auto-antibodies is evidenced by their increasing incorporation into the diagnostic and classification criteria of autoimmune diseases. One of the current concerns arising from the widespread use of auto-antibodies is the observance of adequate use, as opposed to its undiscriminating use that results in an increase of false positive results leading to costly errors in diagnosis, follow-up, and even treatment of the patient. This article attempts to summarize the circumstances when it is timely to order autoantibody tests, and how to interpret them to preserve their clinical utility and control health expenditures(AU)