title: Application of anti-DFS70 antibody and specific autoantibody test algorithms to patients with the dense fine speckled pattern on HEp-2 cells.
abstract: OBJECTIVE
  Whereas antinuclear antibodies (ANAs) detected by indirect immunofluorescence (IIF) have diagnostic significance, the dense fine speckled (DFS) pattern on HEp-2 cells may be an exclusionary marker for ANA-associated rheumatic disease (AARD). The aim of this study was to evaluate a new algorithm considering anti-DFS70 antibodies for routine ANA testing.
  
  
  METHODS
  From ANA requested sequential 10 528 sera, 181 sera samples showing the DFS pattern were additionally tested for anti-DFS70 antibodies by an enzyme-linked immunosorbent assay (ELISA-DFS70) and for specific-ANAs. Specific-ANAs(+)/IIF-DFS(-) control sera samples (n = 50) were also tested.
  
  
  RESULTS
  Of the 181 IIF-DFS-positive sera samples, 82.9% (n = 150) were from non-AARD patients and 112 (61.9%) patients had non-rheumatic diseases (NRD), including the most common clinical feature of dermatitis (18.2%). The ELISA-DFS70 was positive in 109 (60.2%) sera and was negative in all control sera. Specific-ANAs were similarly detected as 25.7% (28/109) and 22.2% (16/72) of ELISA-DFS70(+) and ELISA-DFS70(+) patients, respectively (p > 0.05). The prevalence of non-AARD was 95.1% and 25.1% in the ELISA-DFS70(+)/specific-ANAs(-) and ELISA-DFS70(-)/specific-ANAs (+) groups, respectively.
  
  
  CONCLUSIONS
  In patients with a HEp-2 DFS pattern, the additional ELISA-DFS70 and specific-ANAs test could improve the efficiency of diagnosing AARD. The detection of anti-DFS70 antibodies should be included in test algorithms for ANA testing.
authors.affiliation: a Department of Laboratory Medicine , College of Medicine, Seoul St. Mary's Hospital, the Catholic University of Korea , Seoul , South Korea.
authors.forename: H
authors.initials: H
authors.lastname: Lee
authors.affiliation: a Department of Laboratory Medicine , College of Medicine, Seoul St. Mary's Hospital, the Catholic University of Korea , Seoul , South Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Kim
authors.affiliation: a Department of Laboratory Medicine , College of Medicine, Seoul St. Mary's Hospital, the Catholic University of Korea , Seoul , South Korea.
authors.forename: K
authors.initials: K
authors.lastname: Han
authors.affiliation: a Department of Laboratory Medicine , College of Medicine, Seoul St. Mary's Hospital, the Catholic University of Korea , Seoul , South Korea.
authors.forename: E-J
authors.initials: EJ
authors.lastname: Oh
mesh_terms: D048868:Adaptor Proteins, Signal Transducing / Q000276:immunology*; D000465:Algorithms; D000974:Antibodies, Antinuclear / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology; D045744:Cell Line, Tumor; D003240:Connective Tissue Diseases / Q000175:diagnosis / Q000276:immunology*; D003882:Dermatomyositis / Q000175:diagnosis / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods*; D006801:Humans; D007118:Immunoassay; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000276:immunology; D008947:Mixed Connective Tissue Disease / Q000175:diagnosis / Q000276:immunology; D012216:Rheumatic Diseases / Q000175:diagnosis / Q000276:immunology; D012595:Scleroderma, Systemic / Q000175:diagnosis / Q000276:immunology; D012680:Sensitivity and Specificity; D012859:Sjogren's Syndrome / Q000175:diagnosis / Q000276:immunology*; D014157:Transcription Factors / Q000276:immunology*
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D000974:Antibodies, Antinuclear; D001323:Autoantibodies; C504649:PSIP1 protein, human; D014157:Transcription Factors