title: Multiple nuclear dots and rim-like/membranous IgG isotypes in primary biliary cirrhosis.
abstract: Anti nuclear (ANA) immunomorphological patterns such as multiple nuclear dots (MND) and rim-like/membranous (RL/M) are considered highly specific but little sensitive for primary biliary cirrhosis (PBC) diagnosis. To evaluate frequency and clinical significance of MND and RL/M in PBC patients when investigated at the level of immunoglobulin G isotypes. MND and RL/M pattern have been tested in 141 PBC sera and 230 pathological controls using HEp-2 cells as substrate and anti- total IgG and individual IgG subclasses (IgG1, IgG2, IgG3, IgG4) as specific antisera. One hundred and fourteen of 141 (80%) PBC patients had RL/M or MND pattern when IgG subclasses were used as revealing reagents (vs. 34% when anti total IgG were used, p < 0.0001). The prevalent isotype was IgG1 for RL/M, and IgG2 for MND pattern. None of controls was positive. No clinical differences in terms of severity and outcome of disease have been observed in PBC patients positive for MND and RL/M when investigated with IgG isotypes. The research for RL/M and MND pattern at level of IgG isotype determines a wide gain in terms of sensitivity without a loss of specificity. In Italian PBC patients MND and RL/M pattern did not seem to characterize any subgroup of patients with a poorer prognosis.
authors.affiliation: Department of Clinical Medicine, Alma Mater Studiorum, University of Bologna, Italy. paolo.muratori3@unibo.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Muratori
authors.forename: Alessandro
authors.initials: A
authors.lastname: Granito
authors.forename: Silvia
authors.initials: S
authors.lastname: Ferri
authors.forename: Georgios
authors.initials: G
authors.lastname: Pappas
authors.forename: Umberto
authors.initials: U
authors.lastname: Volta
authors.forename: Rita
authors.initials: R
authors.lastname: Menichella
authors.forename: Francesco B
authors.initials: FB
authors.lastname: Bianchi
authors.forename: Marco
authors.initials: M
authors.lastname: Lenzi
authors.forename: Luigi
authors.initials: L
authors.lastname: Muratori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear / Q000097:blood / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007132:Immunoglobulin Isotypes / Q000097:blood / Q000276:immunology*; D007075:Immunoglobulin M / Q000097:blood; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis / Q000276:immunology*; D008875:Middle Aged; D008928:Mitochondria / Q000276:immunology
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D007074:Immunoglobulin G; D007132:Immunoglobulin Isotypes; D007075:Immunoglobulin M