title: Persistent antinuclear antibodies in children without identifiable inflammatory rheumatic or autoimmune disease.
abstract: One hundred eight children with musculoskeletal pain considered not to be due to an autoimmune or inflammatory disease had an antinuclear antibody (ANA) test performed. Twenty-four of these children were ANA positive on HEp-2 cell substrate at a screening serum dilution of 1:20. A positive ANA test persisted in 21 of 24 of the patients over a mean time period of 38 months (range 1 to 103 months). No sera from any patient at initial evaluation had anti-DNA antibodies by radioimmunoassay or by indirect immunofluorescence on Crithidia luciliae. One patient recently developed elevated anti-DNA (radioimmunoassay) antibodies but still has a negative assay on C luciliae. Four patients had antibodies to core histones by immunoblotting. None had antibodies to Sm, RNP, Ro (SS-A), or La (SS-B) by counterimmunoelectrophoresis. No patient developed an overt inflammatory or autoimmune disease during a mean follow-up period of 61 months (range 13 to 138 months). A child with musculoskeletal pain and a positive test for ANA, but with no clinical evidence at presentation of inflammatory or autoimmune disease, is at low risk of imminently developing such a disease.
authors.affiliation: Department of Pediatrics, University of British Columbia, Vancouver, Canada.
authors.forename: D A
authors.initials: DA
authors.lastname: Cabral
authors.forename: R E
authors.initials: RE
authors.lastname: Petty
authors.forename: M
authors.initials: M
authors.lastname: Fung
authors.forename: P N
authors.initials: PN
authors.lastname: Malleson
mesh_terms: D000293:Adolescent; D000974:Antibodies, Antinuclear / Q000032:analysis*; D001799:Blood Sedimentation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009140:Musculoskeletal Diseases / Q000097:blood / Q000209:etiology / Q000276:immunology*; D010146:Pain / Q000097:blood / Q000209:etiology / Q000276:immunology*
chemical_list: D000974:Antibodies, Antinuclear