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Antinuclear antibody testing in a Turkish pediatrics clinic: is it always necessary?
Pan Afr Med J. 2019; 32:181.PA

Abstract

INTRODUCTION

The term anti-nuclear antibody (ANA) is used to define a large group of autoantibodies which specifically bind to nuclear elements. Although healthy individuals may also have ANA positivity, the measurement of ANA is generally used in the diagnosis of autoimmune disorders. However, various studies have shown that ANA testing may be overused, especially in pediatrics clinics. Our aim was to investigate the reasons for antinuclear antibody (ANA) testing in the general pediatrics and pediatric rheumatology clinics of our hospital and to determine whether ANA testing was ordered appropriately by evaluating chief complaints and the ultimate diagnoses of these cases.

METHODS

The medical records of pediatric patients in whom ANA testing was performed between January 2014 and June 2016 were retrospectively evaluated. Subjects were grouped according to the indication for ANA testing and ANA titers.

RESULTS

ANA tests were ordered in a total of 409 patients during the study period, with 113 positive ANA results. The ANA test was ordered mostly due to joint pain (50% of the study population). There was an increased likelihood of autoimmune rheumatic diseases (ARDs) with higher ANA titer. The positive predictive value of an ANA test was 16% for any connective tissue disease and 13% for lupus in the pediatric setting.

CONCLUSION

in the current study, more than one-fourth of the subjects were found to have ANA positivity, while only 15% were ultimately diagnosed with ARDs. Our findings underline the importance of an increased awareness of correct indications for ANA testing.

Links

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Authors+Show Affiliations

Aygün E
Department of Pediatrics, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, Turkey.
Kelesoglu FM
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, Turkey.
Dogdu G
Department of Pediatric Cardiology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, Turkey.
Ersoy A
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Basbug D
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Akça D
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Çam ÖN
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Akyüz B
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Günsay T
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Kapici AH
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Aydin NG
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Karapinar E
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Atay S
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Saglam N
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Okumus NK
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Can MZ
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Yazici F
Student, Istanbul University, Istanbul Medical Faculty, Millet Caddesi, Fatih, Istanbul, Turkey.
Ömeroglu RE
Department of Pediatric Rheumatology, Istanbul Medical School, Istanbul University, Millet Caddesi, Fatih, Istanbul, Turkey.

MeSH

AdolescentAmbulatory Care FacilitiesAntibodies, AntinuclearAutoimmune DiseasesChildChild, PreschoolConnective Tissue DiseasesFemaleHumansLupus Erythematosus, SystemicMalePredictive Value of TestsRetrospective StudiesRheumatic DiseasesTurkey

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31312295

Citation

Aygün, Erhan, et al. "Antinuclear Antibody Testing in a Turkish Pediatrics Clinic: Is It Always Necessary?" The Pan African Medical Journal, vol. 32, 2019, p. 181.
Aygün E, Kelesoglu FM, Dogdu G, et al. Antinuclear antibody testing in a Turkish pediatrics clinic: is it always necessary? Pan Afr Med J. 2019;32:181.
Aygün, E., Kelesoglu, F. M., Dogdu, G., Ersoy, A., Basbug, D., Akça, D., Çam, Ö. N., Akyüz, B., Günsay, T., Kapici, A. H., Aydin, N. G., Karapinar, E., Atay, S., Saglam, N., Okumus, N. K., Can, M. Z., Yazici, F., & Ömeroglu, R. E. (2019). Antinuclear antibody testing in a Turkish pediatrics clinic: is it always necessary? The Pan African Medical Journal, 32, 181. https://doi.org/10.11604/pamj.2019.32.181.13793
Aygün E, et al. Antinuclear Antibody Testing in a Turkish Pediatrics Clinic: Is It Always Necessary. Pan Afr Med J. 2019;32:181. PubMed PMID: 31312295.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antinuclear antibody testing in a Turkish pediatrics clinic: is it always necessary? AU - Aygün,Erhan, AU - Kelesoglu,Fatih Mehmet, AU - Dogdu,Gafur, AU - Ersoy,Aysenur, AU - Basbug,Dilruba, AU - Akça,Dilara, AU - Çam,Özge Nur, AU - Akyüz,Berat, AU - Günsay,Tülay, AU - Kapici,Ahmet Hakki, AU - Aydin,Nur Gökçe, AU - Karapinar,Edanur, AU - Atay,Sirin, AU - Saglam,Nesibe, AU - Okumus,Nazli Kübra, AU - Can,Melike Zeynep, AU - Yazici,Fatmatüzzehra, AU - Ömeroglu,Rukiye Eker, Y1 - 2019/04/11/ PY - 2017/09/04/received PY - 2018/12/28/accepted PY - 2019/7/18/entrez PY - 2019/7/18/pubmed PY - 2019/7/25/medline KW - Antinuclear antibody KW - autoimmune rheumatologic diseases KW - systemic lupus erythematosus SP - 181 EP - 181 JF - The Pan African medical journal JO - Pan Afr Med J VL - 32 N2 - INTRODUCTION: The term anti-nuclear antibody (ANA) is used to define a large group of autoantibodies which specifically bind to nuclear elements. Although healthy individuals may also have ANA positivity, the measurement of ANA is generally used in the diagnosis of autoimmune disorders. However, various studies have shown that ANA testing may be overused, especially in pediatrics clinics. Our aim was to investigate the reasons for antinuclear antibody (ANA) testing in the general pediatrics and pediatric rheumatology clinics of our hospital and to determine whether ANA testing was ordered appropriately by evaluating chief complaints and the ultimate diagnoses of these cases. METHODS: The medical records of pediatric patients in whom ANA testing was performed between January 2014 and June 2016 were retrospectively evaluated. Subjects were grouped according to the indication for ANA testing and ANA titers. RESULTS: ANA tests were ordered in a total of 409 patients during the study period, with 113 positive ANA results. The ANA test was ordered mostly due to joint pain (50% of the study population). There was an increased likelihood of autoimmune rheumatic diseases (ARDs) with higher ANA titer. The positive predictive value of an ANA test was 16% for any connective tissue disease and 13% for lupus in the pediatric setting. CONCLUSION: in the current study, more than one-fourth of the subjects were found to have ANA positivity, while only 15% were ultimately diagnosed with ARDs. Our findings underline the importance of an increased awareness of correct indications for ANA testing. SN - 1937-8688 UR - https://www.unboundmedicine.com/medline/citation/31312295/Antinuclear_antibody_testing_in_a_Turkish_pediatrics_clinic:_is_it_always_necessary DB - PRIME DP - Unbound Medicine ER -