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Antinuclear antibody (ANA) and ANA profile tests in children with autoimmune disorders: a retrospective study.
Clin Rheumatol. 2000; 19(3):200-3.CR

Abstract

The study objective was to determine the clinical value of positive antinuclear antibody (ANA) and ANA profile tests in children with autoimmune disorders. A retrospective chart review was carried out of all patients under 18 years of age with a positive ANA test (HEp-2 cell substrate, titre > or =1:40) and ANA profile (ELISA) referred to the paediatric rheumatology service at the authors' institution between 1992 and 1996. Of 245 children with a positive ANA test, 134 (55%) had an autoimmune disease, including juvenile rheumatoid arthritis (n = 49), systemic lupus erythematosus (SLE) (n = 40) and others (n = 45). The remaining 111 patients did not have identifiable autoimmune diseases. Patients with autoimmune disorders had significantly higher ANA titres of > or = 1:160 (chi2 = 16, P<0.0001). In addition, of the 245 patients with a positive ANA test, 86 had an ANA profile performed; this was positive in 32 and negative in 54. All 32 patients with a positive ANA profile (100%) had an autoimmune disorder, compared to 22 (41%) of 54 with a negative ANA profile who had autoimmune disorders. Of 22 SLE patients with a positive ANA profile, 16 (73%) had positive anti-dsDNA and 15 (68%) had positive anti-Sm and positive anti-RNP. A positive ANA profile correlated strongly with an ANA titre > or = 1:640 (chi2 = 5.7 , P<0.02). The study demonstrated that only 55% of children with a positive ANA test had a definitive diagnosis of autoimmune disorder. These children tend to have higher ANA titres of > or =1:160. However, a positive ANA profile was strongly correlated with an ANA titre > or =1:640 and highly indicative of an autoimmune disorder (100%). We suggest that in order to reduce cost, an ANA profile should not be performed on all patients with positive ANA, but reserved for those with an ANA titre of > or =1:640 and/or those with a high clinical index of suspicion for autoimmune disorder, especially SLE.

Authors+Show Affiliations

Perilloux BC
Department of Pediatrics, LSU Medical Center and Children's Hospital of New Orleans, LA 70112, USA.
Shetty AK
No affiliation info available
Leiva LE
No affiliation info available
Gedalia A
No affiliation info available

MeSH

Antibodies, AntinuclearArthritis, JuvenileAutoimmune DiseasesChildFemaleHumansLupus Erythematosus, SystemicMaleMusculoskeletal DiseasesRetrospective Studies

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10870654

Citation

Perilloux, B C., et al. "Antinuclear Antibody (ANA) and ANA Profile Tests in Children With Autoimmune Disorders: a Retrospective Study." Clinical Rheumatology, vol. 19, no. 3, 2000, pp. 200-3.
Perilloux BC, Shetty AK, Leiva LE, et al. Antinuclear antibody (ANA) and ANA profile tests in children with autoimmune disorders: a retrospective study. Clin Rheumatol. 2000;19(3):200-3.
Perilloux, B. C., Shetty, A. K., Leiva, L. E., & Gedalia, A. (2000). Antinuclear antibody (ANA) and ANA profile tests in children with autoimmune disorders: a retrospective study. Clinical Rheumatology, 19(3), 200-3.
Perilloux BC, et al. Antinuclear Antibody (ANA) and ANA Profile Tests in Children With Autoimmune Disorders: a Retrospective Study. Clin Rheumatol. 2000;19(3):200-3. PubMed PMID: 10870654.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antinuclear antibody (ANA) and ANA profile tests in children with autoimmune disorders: a retrospective study. AU - Perilloux,B C, AU - Shetty,A K, AU - Leiva,L E, AU - Gedalia,A, PY - 2000/6/28/pubmed PY - 2001/2/28/medline PY - 2000/6/28/entrez SP - 200 EP - 3 JF - Clinical rheumatology JO - Clin Rheumatol VL - 19 IS - 3 N2 - The study objective was to determine the clinical value of positive antinuclear antibody (ANA) and ANA profile tests in children with autoimmune disorders. A retrospective chart review was carried out of all patients under 18 years of age with a positive ANA test (HEp-2 cell substrate, titre > or =1:40) and ANA profile (ELISA) referred to the paediatric rheumatology service at the authors' institution between 1992 and 1996. Of 245 children with a positive ANA test, 134 (55%) had an autoimmune disease, including juvenile rheumatoid arthritis (n = 49), systemic lupus erythematosus (SLE) (n = 40) and others (n = 45). The remaining 111 patients did not have identifiable autoimmune diseases. Patients with autoimmune disorders had significantly higher ANA titres of > or = 1:160 (chi2 = 16, P<0.0001). In addition, of the 245 patients with a positive ANA test, 86 had an ANA profile performed; this was positive in 32 and negative in 54. All 32 patients with a positive ANA profile (100%) had an autoimmune disorder, compared to 22 (41%) of 54 with a negative ANA profile who had autoimmune disorders. Of 22 SLE patients with a positive ANA profile, 16 (73%) had positive anti-dsDNA and 15 (68%) had positive anti-Sm and positive anti-RNP. A positive ANA profile correlated strongly with an ANA titre > or = 1:640 (chi2 = 5.7 , P<0.02). The study demonstrated that only 55% of children with a positive ANA test had a definitive diagnosis of autoimmune disorder. These children tend to have higher ANA titres of > or =1:160. However, a positive ANA profile was strongly correlated with an ANA titre > or =1:640 and highly indicative of an autoimmune disorder (100%). We suggest that in order to reduce cost, an ANA profile should not be performed on all patients with positive ANA, but reserved for those with an ANA titre of > or =1:640 and/or those with a high clinical index of suspicion for autoimmune disorder, especially SLE. SN - 0770-3198 UR - https://www.unboundmedicine.com/medline/citation/10870654/Antinuclear_antibody__ANA__and_ANA_profile_tests_in_children_with_autoimmune_disorders:_a_retrospective_study_ L2 - https://medlineplus.gov/autoimmunediseases.html DB - PRIME DP - Unbound Medicine ER -