Lupus Erythematosus Cell Preparation-Antinuclear Factor Incongruity: A Review of Diagnostic Tests for Systemic Lupus Erythematosus

Koller, Stephen R.; Johnston, Charles G.; Moncure, Charles W.; Waller, Marion

doi:10.1093/ajcp/66.3.495

Cited by 22 publications

(11 citation statements)

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“…These patients were designated as ANA-negative SLE and their clinical picture was notable for the high incidence of photosensitive dermatitis and the low incidence of nephritis and neuropsychiatric manifestations [4]. ANA negative SLE was fi rst introduced by Koller et al with fi ve cases with clinical features similar to SLE [5]. Here we report a young lady presented polyarthritis which was complicated with photosensitive rash and oral ulcer and later diagnosed as ANAnegative SLE.…”

Section: Introductionmentioning

confidence: 82%

A Young Lady with ANA negative SLE with Secondary Anti Phospholipid Syndrome

Gomes¹,

Khan²

2020

Open J Orthop Rheumatol

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Systemic Lupus Erythematosus (SLE) is a chronic, infl ammatory, autoimmune, multisystem connective tissue disease characterized by various autoantibodies to nuclear and cytoplasmic antigens and commonly affects the joints and a variety of organs due to an over activation of the body's immune system. There is wide heterogeneity in presentation of SLE patients, including lung, central nervous system, skin, kidney, and hematologic manifestations. The presence of antinuclear antibodies (ANA) in serum is generally considered a decisive diagnostic sign of SLE. However, a small subset of SLE patients who had the typical clinical features of SLE was reported to show persistently negative ANA tests. Our report describes a 24-yr-old female who presented with the clinical manifestations of SLE such as malar rash, photosensitivity, arthritis, oral ulcer and proteinuria. The serum autoantibodies were all negative except anti ribosomal P. She was also positive for lupus anti-coagulant. She was treated with oral prednisolone, hydroxychloroquine with topical tacrolimus and improved signifi cantly. Three months after, repeat ANA and anti-ds DNA showed persistent negativity but lupus anti-coagulant remained positive. This case suggests that ANA may not be required in the pathogenesis of SLE.

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Section: Introductionmentioning

confidence: 82%

A Young Lady with ANA negative SLE with Secondary Anti Phospholipid Syndrome

Gomes¹,

Khan²

2020

Open J Orthop Rheumatol

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“…The description of ANA-negative lupus was first raised by Koller et al in 1976. They described five patients who were ANA-negative but had clinical features consistent with SLE [ 25 ]. Reports of ANA-negative SLE have decreased markedly in recent years probably because of the use of better substrates in ANA testing.…”

Section: Discussionmentioning

confidence: 99%

ANA Negative Systemic Lupus Erythematosus Leading to CTEPH, TTP-Like Thrombocytopenia, and Skin Ulcers

Changal

Sofi

Altaf

et al. 2016

Case Reports in Rheumatology

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SLE affects almost every organ system, with differing degrees of severity. During its clinical course periods of flares may alternate with periods of remission culminating in disease and therapy related damage. We describe a case of ANA negative SLE with severe thrombocytopenia, cutaneous vasculitis, antiphospholipid antibody syndrome, and pulmonary artery hypertension. As there is no definitive cure for SLE the treatment lies in caring for the individual organ systems involved and simultaneously taking care of the patient as a whole.

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“…LE cell formation is a multistage process requiring four distinct elements, namely nuclear substrate, antinuclear factor or LE factor, phagocytic cell, and complement [4]. The LE cell, initially considered apparently specific for SLE, has been observed in other conditions like rheumatoid arthritis, nephritis, chronic hepatitis, thyroiditis, Sjogren's syndrome, pernicious anemia, ulcerative colitis, red cell aplasia, mixed connective tissue disease, etc.…”

Section: Discussionmentioning

confidence: 99%

Lupus Erythematosus Cells in Bone Marrow: The Only Clue to a Previously Unsuspected Diagnosis of Systemic Lupus Erythematosus

et al. 2013

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Background: Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease characterized by the development of antinuclear antibodies. Nowadays considered outdated, lupus erythematosus (LE) cell preparation served as a screening test for SLE for decades. However, the importance of discovering LE cells on routine cytology cannot be overemphasized. Case: We report the case of a 30-year-old female in whom bone marrow aspiration (BMA) was performed during an investigative workup for pyrexia of unknown origin. The observation of LE cells in direct bone marrow smears (without the use of an anticoagulant) raised the suspicion of SLE, which was later confirmed by antinuclear antibody testing. Conclusion: In the present case, LE cells were observed on BMA performed for the investigation of fever of unknown origin. The unexpected observation of LE cells in BMA smears emphasizes the fact that good morphological observation of marrow aspirates can provide crucial clues to a previously unsuspected diagnosis.

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Lupus Erythematosus Cell Preparation-Antinuclear Factor Incongruity: A Review of Diagnostic Tests for Systemic Lupus Erythematosus

Cited by 22 publications

References 0 publications

A Young Lady with ANA negative SLE with Secondary Anti Phospholipid Syndrome

A Young Lady with ANA negative SLE with Secondary Anti Phospholipid Syndrome

ANA Negative Systemic Lupus Erythematosus Leading to CTEPH, TTP-Like Thrombocytopenia, and Skin Ulcers

Lupus Erythematosus Cells in Bone Marrow: The Only Clue to a Previously Unsuspected Diagnosis of Systemic Lupus Erythematosus

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