Evaluation of Rare Antinuclear Antibody Patterns in a Tertiary Hospital in İzmir

Abstract

Objective: Antinuclear antibody ANA patterns are evaluated as nuclear, cytoplasmic or mitotic on HEp-2 cel l. Although some ANA patterns have been comprehensively studied such as homogenous, speckled or nucleolar staining patterns, rare antinuclear antibody patterns still require further assessment. In this study, the rare pattern was defined as 1% occurring ratio on indirect immunofluorescence assay. Rare ANA patterns were evaluated in a 6-year period retrospectively.Material and methods: The study includes 41921 serum samples that different departments had sent to the tertiary Hospital’s Laboratory of Medical Microbiology for ANA test between January 2010 and December 2015. Serum samples were studied in dilution of 1:100 using HEp20-10/liver biochip Monkey and conjugated with specific antihuman IgG Euroimmun AG, Lubeck, Germany . The fluorescence intensity was evaluated at x400 by immunofluorescence microscope Eurostar III plus . Evaluation was performed as semi-quantitatively from 1+ to 4+. Positive +4 and negative control were used.Results: Of these samples, 9908 23.6% were ANA-IIF-positive. Totally 168 samples were considered as rare autoantibody. Rare patterns were consisted of 49 0.49% midbody, 29 0.29% centriole, 20 0.20% spindle fibers, 21 0.21% anti-golgi, 37 0.37 anti-actin, 3 0.03% rods and rings, and 9 0.09% PCNA proliferating cell nuclear antigen -like. The number of females and males who have rare antibody was 101 and 67, respectively. All of the samples presented a fluorescence of ≥2+. There were 29 patients with systemic autoimmune diseases SAID from the rheumatology department. Another 139 patients were from gastroenterology, endocrinology, neurology and general internal medicine departments.Conclusion: This article shared 6-year experience associated with rare ANA patterns. The significance of our results also emanates from the fact that they document a tertiary hospital’s epidemiological data in Turkey

Keywords

• Antinuclear antibody,rare autoantibody,immunofluorescence pattern

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