title: Outcome of high titer antinuclear antibody positivity in individuals without connective tissue disease: a 10-year follow-up.
abstract: To ascertain the development of disease in a cohort of connective tissue disease (CTD)-negative patients 10 years after testing positive for antinuclear antibody (ANA) in high titer, a telephone survey and serological tests were conducted on a group of CTD-negative patients with high ANA titer identified in a previous study. Thirty-four out of 62 patients (55%) completed only the telephone survey and 27 completed both. The mean length of follow-up was 11.5 years. The ages ranged from 27 to 89 years with the mean being 58.9 years. The sex distribution included 4 (12%) men and 30 (88%) women. Twenty-one out of 27 patients (78%) remained ANA-positive. A total of five patients were diagnosed with CTD with two in the last 5 years. Common symptoms described, in order of frequency, were joint pain, Raynaud's phenomenon, and Sicca symptoms. This study shows that a considerable percentage of CTD-negative individuals with an initial high ANA titer continue to maintain their positivity even after an extended period. It is reassuring, however, that only a small number of these individuals go on to develop CTD. It confirms the fact that the ANA test, despite remaining a useful clinical tool, needs to be used in conjunction with other evidence and clinical judgement when attempting to validate the diagnosis of CTD.
authors.affiliation: Division of Rheumatology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Udara
authors.initials: U
authors.lastname: Wijeyesinghe
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Russell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear / Q000097:blood*; D003240:Connective Tissue Diseases / Q000175:diagnosis / Q000276:immunology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged
chemical_list: D000974:Antibodies, Antinuclear