ANA as an entry criterion for the classification of SLE

被引：48
作者：
Pisetsky, David S. [1 ,2 ,3 ]
Bossuyt, Xavier [4 ]
Meroni, Pier Luigi [5 ]
机构：
[1] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA
[2] Duke Univ, Med Ctr, Dept Immunol, Durham, NC USA
[3] Vet Adm Med Ctr, Med Res Serv, Durham, NC USA
[4] Univ Hosp Leuven, Dept Lab Med, Leuven, Belgium
[5] IRCCS Inst Auxol Italiano, Immunorheumatol Res Lab, Milan, Italy
来源：
AUTOIMMUNITY REVIEWS | 2019年 / 18卷 / 12期
关键词：
Systemic lupus erythematosus; Antinuclear antibody; Classification criteria; HEp2 immunofluorescence assay; Solid phase assays; SYSTEMIC-LUPUS-ERYTHEMATOSUS; ELIA CTD SCREEN; ANTINUCLEAR ANTIBODIES; INDIRECT IMMUNOFLUORESCENCE; CLINICAL UTILITY; AUTOANTIBODIES; IMMUNOASSAY; DISEASE; FLUCTUATION; PREVALENCE;
D O I：
10.1016/j.autrev.2019.102400
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease with highly variable clinical and immunological manifestations. In the classification of patients with this condition, the presence of an antinuclear antibody (ANA) is an important element, with new criteria from the American College of Etheumatology and European League against Rheumatism positioning ANA positivity by an immunofluorescence assay on HEp2-cells (HEp2-IFA) or by an equivalent solid phase assay as the entry criterion. This positioning is based on assumptions about the frequency of ANA positivity in SLE as well as the reliability of the assays. Studies indicate that these assumptions are still a matter of uncertainty since both types of assay show considerable variability and patients with SLE may display negative results in ANA testing. These findings suggest caution in positioning ANA positivity as an entry criterion for classification and point to the value of alternative serological approaches for ANA determinations.
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页数：5
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