Testing for anti-nucleosome antibodies in daily practice: a monocentric evaluation in 1696 patients.
The objective was to report our experience of the detection of anti-nucleosome (anti-Nuc) antibodies (Ab) in a large series of consecutive patients, and to compare these results with those of anti-nuclear and anti-dsDNA Ab. In total, 1696 consecutive patients with suspected or confirmed autoimmune disease were tested over a two-year period. The biological investigation included detection of anti-nuclear, anti-dsDNA and anti-Nuc Ab. Among 1696 sera, 382 (23%) were negative for all Ab tested (anti-nuclear, anti-dsDNA and anti-Nuc) and 1314 (77%) were positive for at least one Ab. Anti-Nuc Ab were positive in 350/1314 patients. In this group, 249/350 (71%) also had positive anti-nuclear and anti-dsDNA, 97/350 (28%) had only positive anti-nuclear Ab without anti-dsDNA Ab and 4/350 (1%) had both anti-dsDNA and anti-Nuc Ab without anti-nuclear Ab. No patient had 'isolated' anti-Nuc Ab. Clinical data were available for 307/350 anti-Nuc positive patients. Systemic lupus erythematosus (SLE) was diagnosed in 240/307 (78%) patients, including 43 SLE patients with negative anti-dsDNA Ab. In conclusion, this study extends the relevance of anti-Nuc Ab to routine use for the diagnosis of connective tissue diseases, mainly anti-dsDNA Ab negative SLE.
Ghillani-Dalbin
P
P
Service d'Immunochimie, Hôpital Pitié-Salpêtrière, Paris, France. pascale.ghillani-dalbin@psl.ap-hop-paris.fr
Amoura
Z
Z
Cacoub
P
P
Charuel
J L
JL
Diemert
M C
MC
Piette
J C
JC
Musset
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003240:Connective Tissue Diseases / Q000175:diagnosis / Q000276:immunology*; D004247:DNA / Q000276:immunology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009707:Nucleosomes / Q000276:immunology*
D000974:Antibodies, Antinuclear; D009707:Nucleosomes; D004247:DNA