Reasons For Requesting the Test in Antinuclear Antibody-Positive Patients and Final Diagnosis of Patients

Year 2023, Volume: 17 Issue: 5, 347 - 353, 25.09.2023

Nimet Öner , Elif Çelikel , Zahide Ekici Tekin , Vildan Güngörer , Serkan Coşkun , Melike Mehveş Kaplan , Cüneyt Karagöl , Nilüfer Tekgöz , Müge Sezer , Merve Cansu Polat , Banu Acar

https://doi.org/10.12956/tchd.1266045

Abstract

Background: The aim of this study was to determine the reasons for the request for antinuclear antibody (ANA) in ANA-positive patients and to determine the final diagnosis of these patients and whether they developed a rheumatologic disease.

Method: In this retrospective study, the files of 559 patients with positive ANA were reviewed. Demographic, laboratory and clinical characteristics of the patients were noted. At the end of follow-up, the final diagnosis was recorded.

Results: The study included 346 patients. 233 of the patients were female, and 113 were male. The mean age at the time of ANA positivity was 9.4  4.7 years, and the mean follow-up period was 19  5.7 months. The most common symptom was myalgia/arthralgia (21.7%). Other common reasons were urticaria, abdominal pain, thrombocytopenia, and proteinuria. Extractable nuclear antigens (ENA) panel results were negative in 170 patients (49.1%). In the ENA panel, dense fine speckled antigen 70 antibodies were most frequently positive in 135 patients (39.2%). At the end of follow-up, 234 patients had no disease. One hundred and one patients were diagnosed with non-rheumatologic diseases, and 11 patients were diagnosed with rheumatologic diseases. Eleven patients with rheumatologic diseases were girls. Rash was the most common symptom in patients with rheumatologic diseases. The positive predictive value of ANA positivity for rheumatologic disease was 3.2% and 1.7% for systemic lupus erythematosus.

Conclusions: Due to the low positive predictive value of ANA testing, patients at risk for autoimmune diseases should be identified and carefully evaluated before ANA is requested.

Keywords

Antinuclear antibody, DFS 70, Systemic lupus erythematosus

Antinükleer Antikor Pozitif Hastalarda Test İsteme Nedenleri ve Hastaların Nihai Tanıları

Abstract

Amaç: Bu çalışmanın amacı ANA-pozitif hastalarda antinükleer antikor (ANA) istenmesinin nedenlerini belirlemek ve bu hastaların son tanılarını ve romatolojik bir hastalık geliştirip geliştirmediklerini saptamaktır.

Yöntem: Bu çalışmada ANA pozitif 559 hastanın dosyaları geriye dönük incelendi. Hastaların demografik, laboratuvar ve klinik özellikleri kaydedildi. Takip sonunda son tanıları kaydedildi.

Bulgular: Çalışmaya 346 hasta dahil edildi. Hastaların 233'ü kadın, 113'ü erkekti. ANA pozitifliği saptandığında, ortalama yaş 9,4  4,7 yıl ve ortalama takip süresi 19  5,7 aydı. En sık görülen semptom miyalji/artraljiydi (%21,7). Diğer yaygın nedenler ürtiker, karın ağrısı, trombositopeni ve proteinüri idi. Ekstrakte edilebilir nükleer antijenler (ENA) panel sonuçları 170 hastada (%49,1) negatifti. ENA panelinde en sık 135 hastada (%39,2) yoğun ince benekli antijen 70 antikorları pozitif bulunmuştur. Takip sonunda 234 hastada hastalık yoktu. Yüz bir hastaya romatolojik olmayan hastalık, 11 hastaya ise romatolojik hastalık tanısı konuldu. Romatolojik hastalığı olan 11 hasta kızdı. Romatolojik hastalığı olan hastalarda döküntü en sık görülen semptomdu. ANA pozitifliğinin romatolojik hastalıklar için pozitif prediktif değeri %3,2 ve sistemik lupus eritematozus için %1,7 idi.

Sonuç: ANA testinin pozitif prediktif değerinin düşük olması nedeniyle, otoimmün hastalıklar açısından risk altında olan hastalar ANA istenmeden önce belirlenmeli ve dikkatle değerlendirilmelidir.

Keywords

Antinükleer antikor, DFS 70, Sistemik lupus eritematozus

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