Session Type: Abstract Submissions (ACR)
The search for antinuclear antibodies (ANA) by indirect immunofluorescence (IIF) on Hep-2 cells is routinely performed as the first step for the biological diagnosis of systemic autoimmune diseases. Anti-DFS70 antibodies are a type of ANA defined by a nuclear dense fine speckled (DFS) IIF pattern, first described in 1994. It has also been reported that anti-DFS70 antibodies were the most frequent type of ANA found in healthy individuals. We therefore conducted a retrospective study on a large number of patients tested positive for anti-DFS70 antibodies
The first group of patients, the anti-DFS+ group, included patients selected among those undergoing routine antinuclear antibodies testing (ANAs) at the Pitié-Salpêtrière hospital (Paris, France). Patient inclusion started on the 1st of July 2011 and ended on the 31st of July 2013. The criterion of inclusion was an ANA testing positive with a DFS pattern at titer higher or equal to 1:80. Anti-DFS70 antibodies were confirmed with QUANTA Flash DFS70 immunoassay (Inova diagnostics). 441 patients were included.
The second group of patients, the thrombosis group, included patients consulting in hematology at the Pitié-Salpêtrière hospital (Paris, France) who were screened for the first time for a factor V Leiden mutation, a test performed only in patients with a history of thrombosis. Patient inclusion started on the 1st of January 2013 and ended on the 31st of December 2013.
Clinical history of all patients was retrospectively analyzed by clinical chart review of medical records
The anti-DFS+ group included 441 patients. The prevalence of SARD among anti-DFS+ patients was low (18%, n=81) consistent with previous reports and the majority of them were followed up in internal medicine departments (82 %). Among them, 51 patients had SLE (11.6 %), 9 RA (2 %), 15 primary Sjogren syndrome (3.4 %) 3 inflammatory myositis (0.7 %) and 2 with mixed connective tissue diseases. Among the other patients, 17 patients had multiple sclerosis (3.9 %) and 16 thyroiditis (3.6 %).
Moreover, we observed an unexpectedly high prevalence of thrombotic events in the anti-DFS+ group (12 %, 54 patients).
We thus constituted a control thrombosis group with patients followed in a single tertiary center for thrombosis. All patients referred (n=67) for the first time to the center for thrombotic events were included. Interestingly, 10.4% of patients in the thrombosis group were positive for anti-DFS antibodies.
Prevalence of arterial thrombosis and venous thrombosis in the whole DFS+ population were respectively of 2.9 %, 6.1 % and prevalence of obstetric syndrome (fetal loss, HELLP or pre-eclampsia) in anti-DFS+ women was 6.3 %. One patient had both arterial and venous thrombosis, another had both arterial thrombosis and obstetric syndrome and four patients had both venous thrombosis and obstetric syndrome.
Presence of DFS70 antibodies on ANA testing may be associated with thrombophilia
J. L. Charuel,
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