The incidence of immunofluorescence patterns and specific autoantibodies observed in autoimmune patients in a tertiary care centre

Abstract

Objectives. Testing for antinuclear antibodies (ANA) facilitates the diagnosis of autoimmune diseases (ADs). Here, we report an incidence of ANA positivity and its patterns by indirect immunofluorescence (IIF) and specific autoantibodies through immunodot assay. Methods. Sera from 993 patients presenting with various ADs were tested by IIF and immunodot assay. Results. ANAs were detected in 39.7%, of which speckled pattern was predominantly observed (50.8%). 56.8% of samples were positive on the immunodot assay, with SSA Ro 60 antibody being the most prevalent (30.7%). Discussion. A significant correlation (p < 0.0001) was observed between patterns and auto-antibodies. Coarse speckled (CS) and homogeneous were overly represented by antibodies SSA Ro 60 (13%) and nucleosomes (5.8%), respectively. Mi-2, PL-7, PL-12, and SP-100 were the rarest autoantibodies specificities found. Conclusions. The presence of a particular IIF pattern is predictive of a specific autoantibody in the sample. Association of IIF patterns and specific autoantibody are relevant for a more accurate diagnosis of disease. ADs from 7.5 to 12%, which indicated a significant health care burden (12). Serum antibodies against nucleus and anti-extractable nuclear antigens (ENA) are widely used in clinical practice and are included in the diagnosis of ADs (13,14). The most common autoantibodies are ANAs, which are conventionally assessed by IIF and include antibodies to both nuclear and cytoplasmic components (15). The immunofluorescence staining patterns and specific autoantibodies are clinically relevant as they are associated with particular ADs (16). Due to the ethnic variations, genetic and environmental factors, there is a significant variation in incidence and disease-specific autoantibodies (17,18). Nonetheless, ANA is frequently found in a considerable proportion of healthy subjects although studies are generally performed in selected populations, such as blood donors or employees, while data on ANA prevalence (19-21) and clinical significance over time (22) in an unselected general population, are limited.

Suggested Rational Considerations for ANA-IF and ENA-Profile Test Requisition: Clinical Manifestation, Gender, Pattern, and Titer of ANA-IF

“…(22) Both patterns were also found as the most frequent patterns in other studies. (14,15,(17)(18)(19) Multiple patterns that reflect the presence of multiple autoantibodies was found in only 6.5% in this study. Multiple autoantibodies could be present in multiple/ overlap syndrome of autoimmune.…”

“…The Indonesian Biomedical Journal, Vol 15,. No.3, June 2023, p.194-295 Print ISSN: 2085-3297, Online ISSN: 2355-9179…”

The association between antinuclear antibody and response to rituximab treatment in adult patients with primary immune thrombocytopenia

“…Thrombocytopenia secondary to connective tissue diseases, especially SLE, are the most commonly encountered forms of secondary ITP [15]. ANAs are the best screening markers for autoimmune disorders [16,17]. However, as pointed out by the international consensus report guidelines, the coexistence of ANAs on their own in the absence of distinctive clinical manifestations suggestive of SLE does not qualify the diagnosis of secondary ITP [1].…”