Antinuclear antibodies. Clinical significance of titers and fluorescence patterns.

Abstract

Eighty-one patients with sera positive for antinuclear antibodies were studied to determine the clinical significance of serum antinuclear antibody titers and immunofluorescent nuclear staining patterns. Attempts were made to (1) determine clinically significant serum ANA titers for various connective tissue diseases; (2) note the specificity of immunofluorescent nuclear staining patterns among various connective tissue diseases; (3) observe the spectrum of serum ANA titers and immunofluorescent nuclear staining patterns among various non-rheumatic diseases; (4) correlate serum ANA titers and immunofluorescent nuclear patterns with the clinical courses of connective tissue diseases. No clinically significant serum ANA titer could be determined either for specific connective tissue diseases or for connective tissue diseases in general, although patients with titers of 1:160 or above more often than not had clinically evident connective-tissue disease. Furthermore, no pattern of nuclear fluorescence proved to be specific for any given clinical syndrome, with a variety of nuclear fluorescent patterns being observed in specific connective-tissue disorders and other non-rheumatic diseases. Only a few correlations could be made between serum ANA titer, nuclear fluorescent pattern, and the clinical courses of connective-tissue disorders. These correlations occurred most frequently with lupus nephritis.