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Antinuclear Antibody-Negative Systemic Lupus Erythematosus in an International Inception Cohort.


ABSTRACT:

Objective

The spectrum of antinuclear antibodies (ANAs) is changing to include both nuclear staining as well as cytoplasmic and mitotic cell patterns (CMPs) and accordingly a change is occurring in terminology to anticellular antibodies. This study examined the prevalence of indirect immunofluorescence (IIF) anticellular antibody staining using the Systemic Lupus International Collaborating Clinics inception cohort.

Methods

Anticellular antibodies were detected by IIF on HEp-2000 substrate using the baseline serum. Three serologic subsets were examined: ANA positive (presence of either nuclear or mixed nuclear/CMP staining), anticellular antibody negative (absence of any intracellular staining), and isolated CMP staining. The odds of being anticellular antibody negative versus ANA or isolated CMP positive was assessed by multivariable analysis.

Results

A total of 1,137 patients were included; 1,049 (92.3%) were ANA positive, 71 (6.2%) were anticellular antibody negative, and 17 (1.5%) had an isolated CMP. The isolated CMP-positive group did not differ from the ANA-positive or anticellular antibody-negative groups in clinical, demographic, or serologic features. Patients who were older (odds ratio [OR] 1.02 [95% confidence interval (95% CI) 1.00, 1.04]), of white race/ethnicity (OR 3.53 [95% CI 1.77, 7.03]), or receiving high-dose glucocorticoids at or prior to enrollment (OR 2.39 [95% CI 1.39, 4.12]) were more likely to be anticellular antibody negative. Patients on immunosuppressants (OR 0.35 [95% CI 0.19, 0.64]) or with anti-SSA/Ro 60 (OR 0.41 [95% CI 0.23, 0.74]) or anti-U1 RNP (OR 0.43 [95% CI 0.20, 0.93]) were less likely to be anticellular antibody negative.

Conclusion

In newly diagnosed systemic lupus erythematosus, 6.2% of patients were anticellular antibody negative, and 1.5% had an isolated CMP. The prevalence of anticellular antibody-negative systemic lupus erythematosus will likely decrease as emerging nomenclature guidelines recommend that non-nuclear patterns should also be reported as a positive ANA.

SUBMITTER: Choi MY 

PROVIDER: S-EPMC7268889 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Antinuclear Antibody-Negative Systemic Lupus Erythematosus in an International Inception Cohort.

Choi May Y MY   Clarke Ann E AE   St Pierre Yvan Y   Hanly John G JG   Urowitz Murray B MB   Romero-Diaz Juanita J   Gordon Caroline C   Bae Sang-Cheol SC   Bernatsky Sasha S   Wallace Daniel J DJ   Merrill Joan T JT   Isenberg David A DA   Rahman Anisur A   Ginzler Ellen M EM   Petri Michelle M   Bruce Ian N IN   Dooley Mary A MA   Fortin Paul R PR   Gladman Dafna D DD   Sanchez-Guerrero Jorge J   Steinsson Kristjan K   Ramsey-Goldman Rosalind R   Khamashta Munther A MA   Aranow Cynthia C   Alarcón Graciela S GS   Manzi Susan S   Nived Ola O   Zoma Asad A AA   van Vollenhoven Ronald F RF   Ramos-Casals Manuel M   Ruiz-Irastorza Guillermo G   Lim S Sam SS   Kalunian Kenneth C KC   Inanc Murat M   Kamen Diane L DL   Peschken Christine A CA   Jacobsen Soren S   Askanase Anca A   Stoll Thomas T   Buyon Jill J   Mahler Michael M   Fritzler Marvin J MJ  

Arthritis care & research 20190612 7


<h4>Objective</h4>The spectrum of antinuclear antibodies (ANAs) is changing to include both nuclear staining as well as cytoplasmic and mitotic cell patterns (CMPs) and accordingly a change is occurring in terminology to anticellular antibodies. This study examined the prevalence of indirect immunofluorescence (IIF) anticellular antibody staining using the Systemic Lupus International Collaborating Clinics inception cohort.<h4>Methods</h4>Anticellular antibodies were detected by IIF on HEp-2000  ...[more]

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