Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Antinuclear antibody (ANA) indirect immunofluorescence (IIF) assay on HEp-2 cells (HEp-2-ANA) is an important element for diagnosis and classification of Systemic Lupus Erythematosus (SLE), but is not considered as a parameter for monitoring disease activity. The objective was to determine whether HEp-2-ANA pattern and titer can be relevant for monitoring SLE disease activity.
Methods: 269 patients meeting the ACR criteria for SLE were consecutively retrieved during a one-year interval and classified into 3 groups according to SLEDAI2K: Remission Group (SLEDAI2K=0); Intermediate Group (SLEDAI2K=1-5); Active Group (SLEDAI2K≥6). In addition to HEp-2-ANA titer and pattern, the following putative parameters of disease activity were determined: 1) serum CH100, C3, C4 and C2; and 2) antibodies to native DNA, denatured DNA, C1q, and nucleosome. 101 of the 269 patients were prospectively reassessed after a six-month interval.
Results: there were 256 women and 13 men (37±11.4 years old) with disease duration of 9.3±7.5 years. Active (n=111), Intermediate (n=111) and Remission (n=47) groups did not differ in age, disease duration and gender. As expected, putative parameters of disease activity differed significantly among the 3 groups, indicating that they actually represent three different disease activity stages. Ten patients were ANA-negative (3.7%), equally distributed among the 3 groups (p=0.534). The nuclear homogeneous pattern (HO) occurred in 57 patients (51.4%) of the Active group and in 11 patients (23.4%) of the Remission group (p=0.003). The nuclear fine speckled pattern (FSp) occurred in 19 patients (40.4%) of the Remission group and in 25 patients (22.5%) of the Active group (p=0.09). Patients with HO pattern had higher SLEDAI (9.2±7.9) than those with FSp pattern (4.8±5.2) (p=0.008). ANA titer was lower in the Remission group (median 1/640) in comparison with the Active (median 1/2560) and Intermediate (median1/1280) groups (p<0.001). In the follow-up analysis, 50 patients remained in the same group (SLEDAI2K change ≤3) and 51 changed disease activity status (SLEDAI2K change ≥4). ANA titer decreased significantly in the 33 patients with decreasing disease activity (p=0.002) but not in the 50 patients with irrelevant change in SLEDAI2K (p=0.677) and in the 18 patients with increasing SLEDAI2K (p=0.080). ROC curve analysis for determination of disease activity showed equivalent areas under the curve (AUC) for ANA titer and all putative disease activity parameters.
Conclusion: ANA pattern and titer are affected by SLE disease activity and can be considered in conjunction with other laboratory and clinical parameters in the assessment of SLE disease activity.
To cite this abstract in AMA style:Prado MS, Dellavance A, Rodrigues SH, Andrade LEC. Immunofluorescence Pattern and Titer of the Antinuclear Antibody Test Correlate with Disease Activity in Patients with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/immunofluorescence-pattern-and-titer-of-the-antinuclear-antibody-test-correlate-with-disease-activity-in-patients-with-systemic-lupus-erythematosus/. Accessed November 27, 2020.
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