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The antinuclear antibody assay: developing criteria for reflexive anti-dsDNA antibody testing in a laboratory setting
-
Wendy Y. Craig
and
Thomas B. Ledue
Published/Copyright:
May 26, 2011
Abstract
Background: We examined the relationship between antinuclear antibody (ANA) data and the presence of anti-double stranded DNA antibodies (anti-dsDNA).
Methods: De-identified demographic, ANA and anti-dsDNA data were available for 30,196 individuals aged ≥20 years, whose sera were submitted sequentially to our laboratory. When multiple sera were received for the same subject, data from the earliest sample were used. Anti-dsDNA frequency was stratified by ANA titer and pattern, sample referral source, and by the patient's age, gender, and diagnosis.
Results: For sera with ANA titer ≥256 and an accompanying diagnosis of systemic lupus erythematosus, anti-dsDNA frequency was 53.7%, 35.3%, and 37.5% for homogeneous, speckled, or multiple ANA patterns, respectively. Among remaining sera with ANA titer ≥256, anti-dsDNA frequency was highest for the homogeneous pattern (15.9%). Anti-dsDNA frequency was three-fold higher among sera submitted by rheumatologists compared with other providers. However, its relative distribution by ANA pattern and titer was similar between these groups. Patient age and gender had no significant effect on anti-dsDNA frequency after ANA data were taken into account.
Conclusions: ANA pattern and titer, together with the diagnosis submitted with the serum sample, can be used to guide decisions for reflexive anti-dsDNA testing in a clinical laboratory setting.
Received: 2011-1-17
Accepted: 2011-3-1
Published Online: 2011-05-26
Published in Print: 2011-07-01
©2011 by Walter de Gruyter Berlin Boston
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Keywords for this article
anti-dsDNA antibody;
antinuclear antibody;
indirect immunofluorescence assay
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- Method comparison: where do we draw the line?
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- Current role of liquid chromatography coupled to mass spectrometry in clinical toxicology screening methods
- Minireview
- Molecular diagnostics for pharmacogenomic testing of fluoropyrimidine based-therapy: costs, methods and applications
- Opinion Paper
- Preanalytical quality improvement: from dream to reality
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- Towards more complete specifications for acceptable analytical performance – a plea for error grid analysis
- Counterpoint
- Closing the brain-to-brain loop in laboratory testing
- General Clinical Chemistry and Laboratory Medicine
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- Comparison of the results from two different External Quality Assessment Schemes supports the utility of robust quality specifications
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- Diagnostic efficiency of truncated area under the curve from 0 to 2 h (AUC0–2) of mycophenolic acid in kidney transplant recipients receiving mycophenolate mofetil and concomitant tacrolimus
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