Medical conditions associated with a positive anti-double-stranded deoxyribonucleic acid.
OBJECTIVE
To explore the associated diseases with positive anti-double stranded (ds) DNA other than systemic lupus erythematosus (SLE), and to determine an association if any, between its level in non-SLE causes.


METHODS
This is a retrospective review of all patients with positive anti-dsDNA assay (more than 200 IU/ml) tested for any underlying etiology from January to December 2007 at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia.


RESULTS
Two hundred and twelve patients with anti-dsDNA antibody testing were evaluated. Of these, 124 patients had SLE (58.5%), while 88 patients (41.5%) had other diseases. Representing non-SLE diseases were: rheumatological disorders in 29 patients (33%), infections in 11 (12%), and malignancy in 6 patients (7%). Strong positive results (>800 IU/ml) were found in only 8 patients (4%) with diagnoses of antiphospholipid antibody syndrome, tuberculosis, osteomylitis, thymoma, lymphoma, sarcoidosis, and 2 autoimmune hepatitis patients. There was a statistically significant association between highly positive anti-dsDNA testing and rheumatological disorders.


CONCLUSIONS
Although positive anti-dsDNA test is common in SLE patients, other diseases should be considered when the anti-dsDNA level is equivocal, and the clinical criteria are not in favor of SLE.
Attar
Suzan M
SM
Department of Internal Medicine, King Abdul-Aziz University Hospital, PO Box 80215, Jeddah 21589, Kingdom of Saudi Arabia. suzan_attar@hotmail.com
Koshak
Emad A
EA
D000974:Antibodies, Antinuclear / Q000097:blood*; D003141:Communicable Diseases / Q000276:immunology*; D004247:DNA / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D009369:Neoplasms / Q000276:immunology*; D012216:Rheumatic Diseases / Q000276:immunology*
D000974:Antibodies, Antinuclear; D004247:DNA