İndirekt İmmünofloresan Yöntemi Kullanılarak Çalışılan Antinükleer Antikor Testinin Üç Yıllık Retrospektif Analizi

Abstract

Amaç: Antinükleer antikor (ANA) testi, sistemik otoimmün romatizmal hastalıkların (SORH) tanısında temel bir tarama aracıdır. İndirekt immünofloresan (IIF) yöntemi, ANA saptamada altın standart kabul edilmekte ve floresan paternlerinin tanımlanması klinik yönlendirmede önem arz etmektedir. Bu çalışmada, üç yıllık bir süre zarfında Başakşehir Çam ve Sakura Şehir Hastanesi’nde ANA testi yapılan hastalarda pozitiflik oranı ve paternlerin dağılımı retrospektif olarak değerlendirilmiştir.

Gereç ve Yöntemler: 1 Ocak 2021- 31 Aralık 2023 tarihleri arasında laboratuvarımıza ANA testi için gönderilen 57,189 örnek, Euroimmun marka HEp-2 hücre içeren IIF kiti ile çalışılmıştır. Otomatik görüntüleme ve analiz sistemi (EUROPattern Suite) kullanılarak sonuçlar değerlendirilmiş, 1:100 ve üzeri titredeki nükleer paternler ANA pozitif kabul edilmiştir.

Bulgular: Toplam 57,189 örneğin 7,422’sinde (%13) ANA pozitifliği saptanmıştır. ANA testi istem sayısının en yüksek olduğu klinikler sırasıyla dahiliye (%29.5), romatoloji (%20.9) ve genel pediatri (%9.3) olmuştur. En yüksek pozitiflik oranları ise romatoloji (%23.5) ve pediatrik romatoloji (%20.6) bölümlerinde gözlenmiştir. Pozitif olguların %83’ü kadın, %17’si erkekti. En sık gözlenen patern benekli (%28.83), ardından yoğun ince benekli (%20.32) ve homojen (%19.60) paternler olmuştur.

Sonuç: Bu çalışma, hastanemizde yapılan ANA test istemleri, pozitiflik oranları ve patern dağılımlarına ilişkin ayrıntılı veriler sunmaktadır. Bulgularımız hem pozitiflik oranlarının hem de paternlerin klinik birimlere ve hasta popülasyonuna göre değişkenlik gösterdiğini ortaya koymuştur. Ayrıca, test istemlerinin farklı uzmanlık alanlarında hastaların klinik bulguları ve semptomlarıyla uyumlu olup olmadığı da değerlendirilmiştir.

Keywords

• Antinükleer antikor
• otoimmün hastalıklar
• indirekt immünfloresan antikor

Three-Year Retrospective Analysis of Antinuclear Antibody Testing by Indirect Immunofluorescence

Abstract

Aim: The antinuclear antibody (ANA) test is a fundamental screening tool in diagnosing systemic autoimmune rheumatic diseases (SARD). The indirect immunofluorescence (IIF) method is considered the gold standard for detecting ANA, and identifying its patterns is crucial in clinical guidance. This study retrospectively evaluated the positivity rate and distribution of patterns in patients who underwent ANA testing at Başakşehir Çam and Sakura City Hospital Hospital over three years.

Material and Methods: Between January 1, 2021, and December 31, 2023, a total of 57,189 samples sent to our laboratory for ANA testing were analyzed using the Euroimmun HEp-2 cell-based IIF kit. The results were evaluated using an automated imaging and analysis system (EUROPattern Suite), and nuclear patterns with a titer of 1:100 or higher were considered ANA positive.

Results: Among the 57,189 samples, 7,422 (13%) were ANA positive. The clinics with the highest number of ANA test requests, in order, were general internal medicine (29.5%), rheumatology (20.9%), and general pediatrics (9.3%). The highest positivity rates were observed in rheumatology (23.5%) and pediatric rheumatology (20.6%) departments. Of the positive cases, 83% were female, and 17% were male. The most frequently observed pattern was speckled (28.83%), followed by fine dense speckled (20.32%) and homogeneous (19.60%) patterns.

Conclusion: This study provides detailed data from our hospital on ANA test requests, positivity rates, and pattern distributions. We found that both positivity rates and patterns vary by clinical department and patient population. Additionally, we assess whether test requisitions align with patients' clinical presentations and symptoms across different specialties.

Keywords

• Antinuclear antibody
• autoimmune diseases
• indirect immunofluorescence antibody

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