Distinctive features of positive anti-cell antibody tests (indirect immunofluorescence on HEp-2 cells) in patients with non-autoimmune diseases

Abstract

Objective

The objective of this study was to determine whether characteristics of positive results in the indirect immunofluorescence assay on HEp-2 cells for anti-cell antibodies (HEp-2 IFA) differ between patients with non-autoimmune diseases (NADs) and patients with systemic autoimmune rheumatic diseases (SARDs).

Methods

Cross-sectional observational study comparing HEp-2 IFA test results in three groups: (a) 558 NAD patients comprising four subgroups (cancer (n = 95), infectious diseases (n = 148), psychiatric diseases (n = 163), common non-infectious chronic diseases (n = 152)); (b) 194 SARD patients; (c) 1217 healthy individuals (HIs). Sera were tested at 1:80 dilution and diluted to the end titer. Slides were analyzed by two independent blinded examiners.

Results

A positive HEp-2 IFA test occurred in 102 (18.3%) NAD patients, 170 (87.6%) SARD patients and 150 (12.3%) HIs. The four NAD subgroups did not differ regarding HEp-2 IFA frequency, titer or pattern. HEp-2 IFA titer was higher in NAD patients than in HIs and both had lower titer than SARD patients. Nuclear dense fine speckled pattern was more frequent in NAD patients and HIs than in SARD patients (p < 0.001). Nuclear homogeneous and nuclear coarse speckled patterns were more frequent in SARD patients than in the other groups (p < 0.001). The nuclear fine speckled pattern was prevalent in all three groups, but presented a gradient in titer across them; HIs and NAD patients had low and intermediary titers, which were significantly lower than in SARD patients (p < 0.001).

Conclusion

Positive HEp-2 IFA frequency, pattern and titer present differential features in NAD and SARD patients, and this attribute adds value to the test in the diagnosis of SARDs.

Keywords

Antinuclear antibodies autoantibodies systemic lupus erythematosus autoimmune diagnosis autoimmune diseases

Get full access to this article

View all access options for this article.

References

Tan

Chan

Sullivan

Rubin

. Antinuclear antibodies (ANAs): diagnostically specific immune markers and clues toward the understanding of systemic autoimmunity. Clin Immunol Immunopathol 1988; 47: 121–141.

Meroni

Schur

. ANA screening: an old test with new recommendations. Ann Rheum Dis 2010; 69: 1420–1422.

Chan

EKL

Damoiseaux

Carballo

et al.

Report of the first international consensus on standardized nomenclature of antinuclear antibody HEp-2 cell patterns 2014–2015. Front Immunol 2015; 6: 412–412.

Mariz

Sato

Barbosa

Rodrigues

Dellavance

Andrade

. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis Rheum 2011; 63: 191–200.

Satoh

Chan

EKL

et al.

Prevalence and sociodemographic correlates of antinuclear antibodies in the United States. Arthritis Rheum 2012; 64: 2319–2327.

Yee

Kelleher

Goldin

et al.

Antinuclear antibodies (ANA) in chronic hepatitis C virus infection: correlates of positivity and clinical relevance. J Viral Hepat 2004; 11: 459–464.

Mohammed

Abdelhafiz

. Autoantibodies in the sera of breast cancer patients: antinuclear and anti-double stranded DNA antibodies as example. J Cancer Res Ther 2015; 11: 341–344.

Guyomard

Salles

Coudurier

et al.

Prevalence and pattern of antinuclear autoantibodies in 347 patients with non-Hodgkin’s lymphoma. Brit J Haematol 2003; 123: 90–99.

Rheumatology.org. ACR endorsed criteria, https://www.rheumatology.org/Practice-Quality/Clinical-Support/Criteria/ACR-Endorsed-Criteria (2018, accessed 16 November 2018).

10.

Watanabe

Kodera

Sugiura

et al.

Anti-DFS70 antibodies in 597 healthy hospital workers. Arthritis Rheum 2004; 50: 892–900.

11.

Wichainun

Kasitanon

Wangkaew

Hongsongkiat

Sukitawut

Louthrenoo

. Sensitivity and specificity of ANA and anti-dsDNA in the diagnosis of systemic lupus erythematosus: a comparison using control sera obtained from healthy individuals and patients with multiple medical problems. Asian Pac J Allergy Immunol 2013; 31: 292–298.

12.

Solans-Laqué

Pérez-Bocanegra

Salud-Salvia

et al.

Clinical significance of antinuclear antibodies in malignant diseases: association with rheumatic and connective tissue paraneoplastic syndromes. Lupus 2004; 13: 159–164.

13.

Massabki

Accetturi

Nishie

da Silva

Sato

Andrade

. Clinical implications of autoantibodies in HIV infection. Aids 1997; 11: 1845–1850.

14.

Laske

Zank

Klein

et al.

Autoantibodies reactivity in serum of patients with major depression, schizophrenia and healthy controls. Psychiat Res 2008; 158: 83–86.

15.

Rubin

. Drug-induced lupus. Expert Opin Drug Saf 2015; 14: 361–378.

16.

Mahler

Meroni

Andrade

et al.

Towards a better understanding of the clinical association of anti-DFS70 autoantibodies. Autoimmun Rev 2016; 15: 198–201.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.12 MB