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Title: The clinical spectrum of antinuclear antibodies associated with the nuclear dense fine speckled immunofluorescence pattern
Authors: Dellavance, Alessandra
Viana, Vilma ST
Leon, Elaine R.
Bonfa, Eloisa SDO
Andrade, Luís EC
Leser, Paulo G.
Fleury Res Inst
Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Keywords: antinuclear antibodies
Issue Date: 1-Nov-2005
Publisher: J Rheumatol Publ Co
Citation: Journal Of Rheumatology. Toronto: J Rheumatol Publ Co, v. 32, n. 11, p. 2144-2149, 2005.
Abstract: Objective. Autoantibodies to lens epithelium-derived growth factor (LEDGF) depict a distinctive nuclear dense fine speckled (DFS) pattern in the indirect immunofluorescence antinuclear antibody assay (IIF-ANA). Definition of the clinical spectrum associated with anti-LEDGF antibodies has been evolving over the last decade. We investigated the frequency, clinical spectrum, and immunologic specificity of the DFS pattern in a general clinical laboratory routine.Methods. All serum samples entered for IIF-ANA determination within a 2 year period were examined for the DFS pattern. Positive samples with consistent clinical information were studied further by IIF with isotype-specific conjugate and immunoblot analysis.Results. Among 13,641 ANA-positive samples, 5081 (37%) presented the DFS pattern. Within a 6 month nested period, there were 650 samples with DFS pattern, and consistent clinical data were available for 81 of these. DFS reactivity was mainly due to IgG. Most samples (86%) presented titer >= 1/640. Eighty of the 81 DFS samples reacted with a 75 kDa band that comigrated with the band elicited by the standard anti-LEDGF serum. Antibodies that were affinity-purified from the 75 kDa band reproduced the DFS pattern on IIF-ANA. The clinical spectrum associated with DFS reactivity included autoimmune diseases (39%) and an array of nonautoimmune conditions (61%). Among the autoimmune patients, over half presented evidence of autoimmune thyroiditis.Conclusion. Anti-LEDGF/p75 antibodies are a common finding among ANA-positive individuals with no evidence of rheumatic autoimmune disease, and should be regarded as a low specificity finding even when in moderate or high titer.
ISSN: 0315-162X
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