Session Information
Date: Sunday, November 5, 2017
Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment Poster I: Biomarkers and Outcomes
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: The indirect immunofluorescence (IIF) test for anti-cell or antinuclear (ANA) antibodies on HEp-2 cells (HEp-2-ANA) is considered the gold standard method for ANA detection. However, this is a very sensitive test and detects autoantibodies also in some healthy individuals and patients with non-autoimmune diseases. The establishment of distinctive HEp-2-ANA features in SARD patients and in healthy individuals has proven to be helpful in the daily medical practice. However, the HEp-2-ANA test is not expected to be requested for healthy individuals, but rather for those seeking for medical care due to some health disorder. Therefore, we aimed to determine the frequency and characteristics of positive HEp-2-ANA tests in individuals affected by a variety of non-autoimmune diseases.
Methods: This is a cross-sectional observational study comparing HEp-2-ANA results in 588 non-autoimmune disease (NAD) patients, 194 patients with systemic autoimmune rheumatic diseases (SARD) and 1,217 healthy individuals. NAD group comprised 4 subgroups: 95 patients with malignancy, 148 with infectious diseases, 163 with psychiatric diseases and 152 with multiple co-morbidities (diabetes mellitus, arterial hypertension, and metabolic syndrome). Sera were tested at 1:80 dilution and diluted to the end titer. Slides were analyzed by two independent blinded examiners at x400 magnification. We followed the anti-cell (AC) pattern nomenclature according to the ICAP (International Consensus on ANA Patterns) recommendations.
Results: A positive HEp-2-ANA result occurred in 102 (18.3%) NAD patients, 170 (87.6%) SARD patients and 150 (12.3%) healthy individuals. The four subgroups of NAD patients did not differ regarding HEp-2-ANA titer or pattern. HEp-2-ANA titer in NAD patients was higher than in heathy individuals and these two groups had lower titer than SARD patients. The nuclear dense fine speckled pattern (AC-2) was more frequent in healthy individuals than in NAD patients (p = 0.029) and was not observed in the SARD group. The nuclear homogeneous (AC-1) and nuclear coarse speckled (AC-5) patterns were more frequent in SARD patients than in the other groups (p < 0.001). The most common pattern in all groups was the nuclear fine speckled (AC-4) pattern, which presented a gradient in titer across the three groups (p < 0.001): healthy individuals and NAD patients had predominantly low and intermediate titer, respectively, and SARD patients had predominantly high titer.
Conclusion: The pattern and titer of HEp-2-ANA positive tests in NAD patients clearly differ from SARD patients. In addition, when compared to healthy individuals, NAD patients present positive HEp-2-ANA tests with slightly higher titer and with lower frequency of the nuclear dense fine speckled (AC-2) pattern.
To cite this abstract in AMA style:
Agustinelli R, Rodrigues SH, Prado M, Mariz H, Andrade LEC. Distinctive Features of Positive Anti-Cell Antibody Tests on HEp-2 Cells (HEp-2-ANA) in Patients with Non-Autoimmune Diseases [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/distinctive-features-of-positive-anti-cell-antibody-tests-on-hep-2-cells-hep-2-ana-in-patients-with-non-autoimmune-diseases/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/distinctive-features-of-positive-anti-cell-antibody-tests-on-hep-2-cells-hep-2-ana-in-patients-with-non-autoimmune-diseases/