Abstract
ContextAnti-DFS70 antibodies are the most frequent antinuclear antibodies (ANA) found in healthy individuals. We assessed the clinical significance of the presence of anti-DFS70 antibodies.MethodsWe defined a group of patients (n = 421) with anti-DFS70 antibodies and a group of patients (n = 63) with a history of idiopathic arterial and/or venous thrombotic disease and/or obstetric complication (i.e. ≥3 miscarriages, fetal death or premature birth with eclampsia). Anti-DFS70 antibodies prevalence was also assessed in a cohort of 300 healthy blood donors.ResultsThe prevalence of thrombotic disease and/or obstetric complication in the 421 patients with anti-DFS70 antibodies was 13.1% (n = 55) and the prevalence of connective tissue disease was 19% (n = 80). Among the 63 patients with a history of thrombosis and/or obstetric complications, 7 (11.1%) had anti-DFS70 antibodies and among the latter, 5 had no common thrombophilic factor. In contrast, the prevalence of anti-DFS70 antibodies was of 3.0% (9 out of 300) in healthy donors. Finally, the Activated Partial Thromboplastin Time (aPTT) ratio of patients with a history of thrombosis and anti-DFS70 antibodies was lower than the aPTT ratio of other patients, suggesting that thrombotic patients with anti-DFS70 antibodies may have a hypercoagulable state.ConclusionWe described here for the first time an immune procoagulant state involving anti-DFS70 antibodies.
Highlights
The search for antinuclear antibodies (ANA) by indirect immunofluorescence (IIF) on HEp-2 cells is routinely performed as the first step for the biological diagnosis of systemic autoimmune diseases [1,2,3]
The Activated Partial Thromboplastin Time ratio of patients with a history of thrombosis and anti-DFS70 antibodies was lower than the aPTT ratio of other patients, suggesting that thrombotic patients with anti-DFS70 antibodies may have a hypercoagulable state
Trained immunologist can distinguish this IIF pattern from the ones commonly observed in connective tissue diseases (CTD) and we have recently shown that the dense fine speckled (DFS) IIF pattern corresponded to the presence of anti-Lens Epithelium Derived Growth Factor antigen (LEDGF) antibodies detected by specific assays [6]
Summary
The search for antinuclear antibodies (ANA) by indirect immunofluorescence (IIF) on HEp-2 cells is routinely performed as the first step for the biological diagnosis of systemic autoimmune diseases [1,2,3]. Anti-DFS70 antibodies are a type of ANA defined by a nuclear dense fine speckled (DFS) IIF pattern, first described in 1994 (Fig 1) [4]. Trained immunologist can distinguish this IIF pattern from the ones commonly observed in connective tissue diseases (CTD) and we have recently shown that the DFS IIF pattern corresponded to the presence of anti-LEDGF antibodies detected by specific assays [6]. A more recent study indicated that anti-DFS70 antibodies were observed at a lower frequency in healthy donors (3%) while they were absent in CTD [12]. We show that a significant proportions of patients harboring anti-DFS70 antibodies unexpectedly presented with a history of thrombosis (arterial or venous) or obstetric complications including miscarriages, fetal death and premature birth with eclampsia that were not explained by the presence of common thrombophilic factors [13]
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