Low avidity antibodies to dsDNA as a diagnostic tool.

J C Nossent, V Huysen, R J Smeenk, A J Swaak

Dr Daniel den Hoed Clinic, Department of Rheumatology, Rotterdam, The Netherlands.

An evaluation of the diagnostic value of low avidity antibodies to double stranded DNA (dsDNA) measured by the polyethylene glycol (PEG) assay was undertaken. By routine screening low avidity anti-dsDNA were detected in the serum samples of 106 hitherto unknown patients. Clinical data of these patients were collected and when only low avidity anti-dsDNA was present (n = 92) a varied disease spectrum was observed. A diagnosis of systemic lupus erythematosus (SLE) was established in 48/92 (52%), lupus-like disease in 21/92 (23%), autoimmune hepatitis in 9/92 (10%), rheumatoid arthritis in 8/92 (9%), and mixed connective tissue disease in 2/92 (2%) of all patients. Patients with definite SLE were all older than 45 years and predominantly female (46/48, 96%). They showed a remarkably low incidence of renal disease (2/69, 3%). When high avidity antibodies to dsDNA as measured by the Farr assay were present as well (n = 14) a diagnosis of SLE could be established in 12/14 (86%) of all patients, indicating the secondary importance of low avidity anti-dsDNA in these patients.

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