title: Is identification of anti-SSA and/or -SSB antibodies necessary in serum samples referred for antinuclear antibodies testing?
abstract: BACKGROUND
  Anti-SSA and -SSB antibodies are clinically important antinuclear antibodies in patients with systemic rheumatic diseases.
  
  
  METHODS
  We evaluated fluorescence characteristics and clinical significance of anti-SSA and -SSB and explored whether identification of these antibodies was necessary in clinical application.
  
  
  RESULTS
  Of 4,978 consecutive samples, 259 showed anti-SSA or -SSB reactivity, clinical information of which were analyzed. Compared with SSA+SSB- and SSA-SSB+ group, SSA+SSB+ group showed a lower proportion (0.5%) of negative specimens detected with antinuclear antibody assay and a higher proportion (53.5%) of specimens with high titer. Anti-SSA- and/or -SSB-positive samples presented various patterns. However, 64.6% of SSA+SSB+ samples presented speckled pattern, significantly higher than SSA+SSB- and SSA-SSB+ samples. A total of 475 specimens containing anti-SSA or -SSB were obtained from 302 individuals. Clinical information was obtained for 259 of them, which were further analyzed. The prevalence of Sjögren syndrome (SS) was significantly higher, and that of other diseases was lower in SSA+SSB+ than in SSA+SSB- group. Of the 259 individuals, 71 anti-SSA- and/or -SSB-positive patients had blood drawn on 2 or more occasions over the 2-year study period. The number of tests per patient was 2.7 ± 1.1. In 7 of the 71 patients, anti-SSA was observed in some but not all samples, so was anti-SSB in 6.
  
  
  CONCLUSIONS
  In conclusion, the identification of anti-SSA and -SSB antibodies is necessary, when corresponding diseases are suspected. The specificity of anti-SSA for the diagnosis of SS could be improved, when combined with anti-SSB. SS patients need not be identified frequently for anti-SSA and -SSB because of their stability.
authors.affiliation: Department of Laboratory Diagnostics, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Zaixing
authors.initials: Z
authors.lastname: Yang
authors.forename: Yan
authors.initials: Y
authors.lastname: Liang
authors.forename: Renqian
authors.initials: R
authors.lastname: Zhong
mesh_terms: D000974:Antibodies, Antinuclear / Q000097:blood*; D001327:Autoimmune Diseases / Q000097:blood*; D016009:Chi-Square Distribution; D006801:Humans; D012698:Serologic Tests / Q000379:methods*; D018709:Statistics, Nonparametric
chemical_list: D000974:Antibodies, Antinuclear; C035356:SS-A antibodies; C035357:SS-B antibodies