Extended report
Detection and identification of antinuclear antibodies (ANA) in a
large and consecutive cohort of serum samples referred for ANA testing
I Peenea, L Meheusb, E M Veysa, F De Keysera
a Department of
Rheumatology, Ghent University Hospital, Belgium, b Innogenetics NV, Ghent, Belgium
Correspondence to: Dr F De Keyser, Department of Rheumatology 0K12IB, University Hospital Ghent, De pintelaan 185, 9000 Ghent, Belgium filip.dekeyser{at}rug.ac.be
Accepted for publication 3 May 2001
OBJECTIVE
To provide
data on (a) the probability of detecting
antinuclear antibodies (ANA) in a large and consecutive cohort of serum samples referred for ANA testing and (b) the
probability of detecting more specific antinuclear reactivities
(anti-DNA and anti-extractable nuclear antigens (anti-ENA)) in serum
samples with a positive screening test (indirect immunofluorescence on
HEp-2 cells).
METHODSSerum
samples from 10 550 consecutive patients sent to the laboratory for
ANA detection were analysed. In ANA positive serum samples (23.5% of
referred serum samples), ANA were identified by indirect
immunofluorescence on Crithidia, by
immunodiffusion, and by line immunoassay. Because anti-SSA
antibodies were the most frequently identified ANA, sensitively
detected by line immunoassay, additional immunoassays were developed to
confirm the specificity of the line immunoassay result.
RESULTSAt least one
fine reactivity could be identified in 21.1% of ANA positive serum
samples: anti-dsDNA in 3.2%; anti-ENA (anti-SSA 10.5%, anti-SSB
6.7%, anti-RNP 2.7%, anti-Sm 1.8%, anti-Scl70 1.2%, anti-Jo-1
0.2%) in 15.8%, rRNP and anti-Cenp-B in respectively 0.5% and 4.0%.
Multiple reactivities were found in 7.9%. For anti-ENA antibodies,
line immunoassay was more sensitive than immunodiffusion (15.4%
v 7.7%; p<0.0001). The sensitive detection
of anti-SSA antibodies by line immunoassay was confirmed by additional assays.
CONCLUSIONSThe data
from this analysis are useful in estimating the probabilities of
detecting specific ANA. Line immunoassay was shown to be a
sensitive test for the detection of anti-ENA antibodies.
© 2001 by Annals of the Rheumatic Diseases
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