Effective Use of Autoantibody Tests in the Diagnosis of Systemic Autoimmune Disease

Abstract

Screening for disease-specific autoantibodies may be useful in asymptomatic ANA-positive individuals as a means of evaluating the risk of developing a systemic autoimmune disease such as systemic lupus erythematosus (SLE), polymyositis/dermatomyositis (PM/DM), scleroderma (SSc), Sjögren's syndrome (SS), rheumatoid arthritis (RA), or primary biliary cirrhosis (PBC) in the future. In patients with known or suspected systemic autoimmune disease, a panel of disease-specific markers may help to establish a diagnosis and to assess the prognosis. The great strides in autoantibody testing over the last 20 years make it feasible to use specific autoantibody markers to improve diagnostic accuracy in systemic autoimmune disease. New technology enabling screening for multiple autoantibodies may further enhance the clinical usefulness of autoantibody testing, making it possible to diagnose autoimmune disease in its earliest stages and to intervene before serious end organ damage occurs.

Prevalence and clinical significance of elevated antinuclear antibody test in children and adult patients with idiopathic thrombocytopenic purpura

“…It is estimated that 10-15% of healthy people over the age of 65 years ANA positive although the titers are usually ‡1:160. Approximately 3% of normal individuals are ANA positive at a 1:320 serum dilution, and 32% are ANA positive at 1:40 serum dilution [14]. Usually a titer of ‡1:160 is significant in the diagnosis of CTD [8].…”

Disease Association and Arthritogenic Potential of Circulating Antibodies against the α1,4-Polygalacturonic Acid Moiety

“…It has long been known to be associated with autoantibodies, most notably rheumatoid factors (RFs) and anti-cyclic citrullinated peptide Abs (CCP-Abs), both of which have been widely used as diagnostic markers for RA since their discovery (3)(4)(5)(6). However, association of autoantibodies in RA is likely to extend well beyond RFs and CCP-Abs.…”

Serum concentrations of Flt-3 ligand in rheumatic diseases

“…Immune dysfunction and vascular abnormalities are thought to be the common features in rheumatic diseases including rheumatoid arthritis (RA), polymyositis/dermatomyositis (PM/DM), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD) or Sjögren's syndrome (SjS) (1,2). For example, autoantibodies, Raynaud's phenomenon, nailfold bleeding (NFB) and skin ulcers are frequently seen in various rheumatic diseases.…”