Session Type: Abstract Submissions (ACR)
The recently recognized nuclear dense fine speckled immunofluorescence (IF) ANA pattern is associated with antibodies to the dense fine speckled 70 (DFS70) antigen. Presence of antiDFS70 may identify populations with a low prevalence of autoimmune rheumatic disease. Long-term followup evaluation of the associations of antiDFS70 is limited.
Serum samples sent for ANA tests to our clinical laboratory were tested for ANA by a multiplex bead assay and HEp2 IF in 2011. Specimens with a positive IF ANA but negative for tested ANA subsets were identified. Randomly selected samples from that population were tested using a commercial anti-DFS70 ELISA and chart reviews were done on positive samples. Long-term followup based on chart review was performed in 2014.
Long-term followup (at least 6 months, range 6 to 36 months) was available for 32 patients. No definitive autoimmune rheumatic disease was diagnosed in any patient. One patient was treated with hydroxychloroquine for possible undifferentiated connective tissue disease, in part because of the persistent positive ANA, arthralgias, and hearing problems felt most likely to be due to otosclerosis. One patient was diagnosed with celiac disease, one patient had idiopathic glomerulosclerosis with other features of autoimmune disease, and one patient had idiopathic pulmonary fibrosis requiring lung transplant. Two patients developed multiple sclerosis. Common clinical symptoms were arthralgias and/or myalgias (7/32) including 4 diagnosed with fibromyalgiaAsthma was found in 3 patients, irritable bowel syndrome in 3 patients, and headaches (including migraines) in 5. Two patients were diagnosed with depression. No chronic atopic dermatitis, cystitis or malignancy (diagnoses previously reported with antiDFS70) were found.
None of our subjects had an identified autoimmune rheumatic disease on long-term followup. From this U.S. population, although small, we provide additional support for the proposal that sera with only DFS70 antibodies may help identify patients who do not have a rheumatologic disease despite a positive ANA IF test.
M. H. Wener,
Inova Diagnostics, Inc.,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/anti-dense-fine-speckled-70-antibodies-long-term-followup-study-of-clinical-associations-in-a-us-laboratory-patient-population/