首页> 外文期刊>Frontiers in Medicine >Recognition and Relevance of Anti-DFS70 Autoantibodies in Routine Antinuclear Autoantibodies Testing at a Community Hospital
【24h】

Recognition and Relevance of Anti-DFS70 Autoantibodies in Routine Antinuclear Autoantibodies Testing at a Community Hospital

机译:抗DFS70自身抗体在社区医院常规抗核自身抗体检测中的认识和相关性

获取原文
       

摘要

Antinuclear autoantibodies (ANA) displaying a dense fine speckled pattern (DFS, ICAP AC-2) on HEp-2 cells are frequently observed in clinical laboratory referrals, often associated with anti-DFS70 specificity. Anti-DFS70 positive patients rarely develop systemic autoimmune rheumatic disease (SARD), especially in the absence of clinical evidence or additional anti-extractable nuclear antigen (ENA) antibodies, prompting suggestions that an isolated DFS70-specific ENA may be an exclusionary finding for SARD. In this study, the frequency and diagnostic significance of anti-DFS70 autoantibodies was investigated in a community hospital cohort of patients undergoing routine ANA testing. ANA screening was performed by HEp-20-10-based indirect immunofluorescence, followed by ENA profiling using a multiparametric line immunoassay (LIA). Of 6,511 patient samples tested for ANA in 2016, the DFS pattern was identified in 1,758 (27.0%), 720 (41.0%) of which were anti-DFS70 positive by LIA. Of these, 526 (73.1%) revealed isolated anti-DFS70 reactivity, while 194 (26.9%) showed additional ENA specificities. Among 1,038 anti-DFS70 negative or borderline samples, 778 (75.0%) were ENA profile negative, while the remaining 260 (25.0%) showed a varied presence of other ENA specificities. Chart reviews of patients with an isolated anti-DFS70 ANA affirmed that ANA-related SARD is rare in the absence of clinical evidence or other ENA specificities, there being no case thus far identified. Rheumatoid arthritis patients occasionally had an isolated anti-DFS70 ANA and were positive for rheumatoid factor and anti-cyclic citrullinated peptide antibodies. In conclusion, the recognition of a DFS ANA pattern using a mitotic-rich HEp-2 substrate, followed by confirmation of anti-DFS70 specificity should be a routine ANA testing service. Use of an expanded ENA profile and clinical correlation is necessary to affirm the “isolation” of anti-DFS70 as the cause of an ANA. Recognition of isolated anti-DFS70 ANA enables reassurance of patients that SARD is unlikely, thus avoiding referral for more extensive testing. The presence of significant elevations of other ENAs may reflect SARD and warrants close clinical correlation and follow-up.
机译:在临床实验室转诊中经常观察到在HEp-2细胞上显示密集的斑点图案(DFS,ICAP AC-2)的抗核自身抗体(ANA),通常与抗DFS70特异性相关。抗DFS70阳性的患者很少发展为全身性自身免疫性风湿病(SARD),尤其是在缺乏临床证据或其他抗提取性核抗原(ENA)抗体的情况下,这提示分离的DFS70特异性ENA可能是SARD的排除性发现。在这项研究中,在接受常规ANA测试的社区医院队列中研究了抗DFS70自身抗体的频率和诊断意义。 ANA筛选通过基于HEp-20-10-的间接免疫荧光进行,然后使用多参数线免疫分析(LIA)进行ENA分析。在2016年为ANA测试的6,511例患者样本中,DFS模式在1,758(27.0%)中被确定,其中720(41.0%)被LIA抗DFS70阳性。在这些中,有526个(73.1%)显示出分离的抗DFS70反应性,而194个(26.9%)显示了另外的ENA特异性。在1,038份抗DFS70阴性或临界样品中,有778份(75.0%)为ENA阴性,而其余260份(25.0%)显示出其他ENA特异性的变化。对患有分离的抗DFS70 ANA的患者进行的病历检查证实,在缺乏临床证据或其他ENA特异性的情况下,与ANA相关的SARD很少见,迄今为止尚无病例。类风湿关节炎患者偶尔会分离出抗DFS70 ANA,并且类风湿因子和抗环瓜氨酸肽抗体均为阳性。总之,使用有丝分裂丰富的HEp-2底物识别DFS ANA模式,然后确认抗DFS70特异性应该是常规的ANA测试服务。必须使用扩大的ENA分布图和临床相关性来确认抗DFS70的“分离”是ANA的原因。识别出分离的抗DFS70 ANA可以使患者确信SARD不太可能,从而避免了转诊进行更广泛的测试。其他ENA显着升高可能反映了SARD,并需要密切的临床相关性和随访。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号