Open AccessComparative Study of Immunofluorescent Antinuclear Antibody Test and Line Immunoassay Detecting 15 Specific Autoantibodies in Patients With Systemic Rheumatic Disease
Author(s) -
Lee Sun Ah,
Kahng Jimin,
Kim Yonggoo,
Park YeonJoon,
Han Kyungja,
Kwok SeungKi,
Park Sunghwan,
Oh EunJee
Publication year - 2012
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.21522
Subject(s) - anti nuclear antibody , medicine , antibody , autoantibody , extractable nuclear antigens , immunology , microbiology and biotechnology , biology
Based on the currently proposed algorithms, antibodies specificities (sp‐ ANA s) are identified mainly in samples positive for fluorescent antinuclear antibodies ( FANA ) screening tests. The purpose of the present study was to compare diagnostic performances of FANA and line immune assay ( LIA ) detecting 15 sp‐ ANA s in patients with systemic rheumatic diseases ( SRD ). In 948 sera from the patients with SRD ( n = 590) and non‐ SRD ( n = 358), we evaluated the fluorescent patterns and intensities in the FANA test, and compared the FANA results with sp‐ ANA s against n RNP , S m, SS ‐ A , R o52, SS ‐ B , S cl‐70, PM / S cl, J o‐1, CENP B , PCNA , ds DNA , nucleosome, histone, ribosomal‐ P , and M2. The sensitivity and specificity was 75.9% and 52.5% of FANA test and 62.0% and 84.4% of sp‐ ANA s test for SRD detection. The overall agreement between FANA and sp‐ ANA s results was 69.2% (Kappa coefficient; 0.404). According to the clinical diagnosis, the levels of agreement varied from 33.3% to 83.1%. The positive predictive values of each FANA pattern for the detection of sp‐ ANA s were less than 50% except for the discrete speckled pattern (91.7%). The 1:100 intensity of FANA as well as the monoreactivity of LIA , anti‐ SSA (−)/anti‐ R o52(+), or FANA (−)/sp‐ ANA s(+) was associated with non‐ SRD . Antibodies against ribosomal‐ P or PCNA were specific for systemic lupus eryhthematosus. This study highlights the need for careful interpretation of FANA test results to assess sp‐ ANA s and the application of sp‐ ANA s tests including less‐common autoantibodies. In patients with clinical suspicion of SRD , screening with both FANA and sp‐ ANA s tests could improve diagnostic efficiency. J. Clin. Lab. Anal. 26:307‐314, 2012. © 2012 Wiley Periodicals, Inc.