Prevalence Of Positive Antinuclear Antibodies Research Articles

The Prevalence of Serum Anti Nuclear Antibodies in Children Treated With Anti-Epileptics

To evaluate the prevalence of positive serum antinuclear antibody (ANA) in children with epilepsy using three major antiepileptic drugs (phenytoin, carbamazepine and ethosuximide), 60 children under 18 years with epilepsy who were referred to pediatric neurology clinic or had admitted to neurology ward in Children Hospital in Tehran, Iran, were entered our study. They had been treated with one of the three antiepileptic drugs (carbamazepin, phenytoin, ethosuximide) with suitable dose for at least one month. The patients were divided into two groups according to the classification of the International League Against Epilepsy (ILAE): drug-resistant and drug-responsive. We studied the epidemiological and clinical characteristics and also serum ANA of the patients in both groups. In this research, we studied ANA in 60 epileptic children. 30 patients were diagnosed with drug resistant epilepsy and the other 30 were drug responsive. None of them showed the clinical manifestations of lupus erythematosus. As a whole, 7 patients (11.7%) were ANA-positive, 6.7% of drug resistant and 16.7% of drug responsive group showed this finding. There was no relationship between drug resistancy and ANA according to statistical studies (P=0.21). Although in our study, epidemiological and clinical data of the patients was reported in two separate groups of resistant or responsive to antiepileptic drugs, and no meaningful statistical difference was found between these two groups. Overally in our study, the prevalence of positive ANA in patients receiving antiepileptic drugs was less in comparison with previous studies and was more common in males. Finally, we suggest a more comprehensive and extensive study with more cases and further follow-up period in order to find the cause of immunological reactions to antiepileptic drugs in children with epilepsy.

Clinical and Laboratory Evaluation of Acute Pericarditis Associated with Antinuclear Antibodies Positivity.

Up to 30% of patients with acute pericarditis develop recurrent pericarditis. Acute pericarditis may be a manifestation of an underlying systemic autoimmune disease. Therefore, we evaluated the characteristics of patients with acute pericarditis according to antinuclear antibodies (ANA) positivity/negativity. Participants with acute pericarditis and negative ANA (n=29), recurrent pericarditis with positive ANA (n=30) and healthy controls (n=11) were examined. The groups were compared using serum parameters (ANA, C-reactive protein, leucocyte count, erythrocyte sedimentation rate, total antioxidant status, nitric oxide (NO), and oxidative stress index (OSI)) and imaging techniques (electrocardiogram, echocardiography, cardiovascular magnetic resonance, and venous Doppler ultrasound). In females, acute pericarditis associated with ANA occurred more frequently (p<0.001). ANApositive acute pericarditis had significantly lower NO and OSI (p<0.05 and p<0.001, respectively) and pericardial inflammation on magnetic resonance. We found a pulmonary embolism in one patient with positive ANA. Slow venous flow (SVF) occurred more often in acute pericarditis associated with ANA than in the ANA-negative group on venous ultrasound (p<0.05). The prevalence of positive ANAs was 1.6 times higher among SVF patients than in controls. This study suggests that acute pericarditis associated with ANA is more common in middle- aged females. SVF and lower oxidative stress tests were more common in patients with ANAassociated acute pericarditis. Acute pericarditis associated with ANA could be considered as a hypercoagulable state. Therefore, all newly diagnosed pericarditis patients (especially females) should be checked for ANA positivity. Awareness of this coexistence should be promptly addressed to establish management strategies.

Presence of Serum Antinuclear Antibodies Does Not Impact Outcomes in HBV-Related Acute-on-Chronic Liver Failure.

Background The aim of this study was to provide new insights into the prevalence of positive antinuclear antibody (ANA) in patients with HBV-related acute-on-chronic liver failure (ACLF) and its impact on clinical outcomes. Methods A total of 116 patients with HBV-related ACLF treated at three clinical centers were retrospectively recruited. Serum concentrations of ANA were detected using the enzyme-linked immunosorbent assay kit. Multiple nuclear dots, rim-like, and centromere patterns of ANA were detected using indirect immunofluorescence assay on HEp-2 cells. Results Among the 116 patients with HBV-related ACLF, 17 (14.66%) were ANA positive. Most patients in both ANA positive and negative groups were males (88.2% and 83.8%). Patients with negative ANA had a higher international normalized ratio, model for end-stage liver disease (MELD), and MELD-sodium scores than those with positive ANA (all P < 0.05). Multiple nuclear dot pattern was detected in half of the patients (8/17, 47.06%), rim-like/membranous pattern was found in six patients, and centromere pattern was detected in the last three patients. For patients with ANA (+), IgM was lower, and it was positively correlated with IgG. For patients with ANA (-), C3 was positively correlated with C4, and both C3 and C4 were negatively correlated with INR and MELD (all P < 0.05). In addition, TBIL, INR, WBC, and PLT, but not ANA, resulted as independent risk factors associated with 90-day mortality. Conclusion Positive ANA is frequent in HBV-related ACLF, and it does not seem to be associated with poor outcomes, but the pathogenesis of ACLF may be different between ANA (+) and ANA (−) groups.

The incidence, risk factor, and time to develop rheumatologic diseases after isolated inflammatory eye diseases: a 12-year cohort study.

The incidence, risk factors, and time to diagnosis of rheumatologic disease (RD) in patients with isolated inflammatory eye diseases (IED) were investigated. A 12-year bidirectional cohort study was conducted in IED patients who were tested for antinuclear antibody (ANA) and rheumatoid factor (RF). Patients with prior RD were excluded. Impacts of relevant symptoms, signs, and laboratory investigations were analyzed. Seventy-five patients presented with IED including scleritis, anterior uveitis (AU), retinal vasculitis (RV), keratopathy, and optic neuritis (OP). AU, RV, keratopathy, and OP were associated with RD development. The incidence of RD was 36% during 12 years. RD developed most frequently in AU (55.5%) and RV (22.2%). The longest duration for RD development was 5.5 years. Prevalence of positive ANA and RF were 57.3% and 13.3%, respectively. The three most common RDs developed after IEDs were spondyloarthropathy (44.4%), systemic lupus erythematosus (SLE) (18.5%), and Sjogren's syndrome (pSS) (11.1%). The risk factors of RD from univariate analysis were age below 35 years old at onset of IED [relative risk (RR) 3.45; 95% CI (1.13-10.55), p =0.026], positive pertinent findings from history [RR 2.125; 95% CI (1.39-3.25), p<0.001], and physical examination [RR 3.23; 95% CI (1.84-5.66), p<0.001]. Multivariable logistic regression showed that bilateral eye involvement of IED was the significant risk of RD [RR 4.33; 95% CI (1.57-11.96), p=0.004]. IED patients with bilateral eye involvement had shorter time to develop RD (p=0.018). Positive ANA was the predictor for SLE and pSS in RV or OP patients [RR 2.00; 95% CI (1.14-3.52), p=0.04]. IED with bilateral eye involvement was the risk of RD development. Positive ANA was the predictor of RD in RV and OP patients, but not for the other IEDs. Follow-up period of at least 5 years was required to identify RD. • Bilateral involvement of isolated inflammatory eye disease was a significant risk factor of rheumatologic disease development.

High prevalence of antinuclear antibodies in patients following venous thromboembolism.

Growing evidence suggests that activation of blood coagulation exerts protective functions during inflammation. However, it has been hypothesized that dysregulated immunothrombosis may lead to venous thromboembolism (VTE). Antinuclear antibodies (ANAs) are considered to promote the thrombotic tendency but there have been no reports on the association between ANAs and VTE. The objective of this study was to investigate if the presence of ANAs is associated with VTE. We enrolled 283 consecutive patients, aged 18-66 years old, following a VTE episode, and 165 age-matched healthy controls. Patients with documented autoimmune diseases (n = 56, 19.79%), including antiphospholipid syndrome (n = 48, 16.9%), were excluded. Antinuclear antibodies were determined based on immunofluorescence. The specific immunofluorescence patterns observed at serum dilution equal to or greater than 1:100 were considered as positive ANAs. The final analysis included 227 patients (aged 41.07 ±11.4, 98 males, 129 females) following provoked (n = 111) or unprovoked (n = 116) VTE. Ninety-four (42.2%) patients had positive ANAs, including 32 (33.3%) with ANAs titer ≥1:320, whereas as few as 14 (8.4%) controls had positive ANAs (p < 0.007). ANA-positive patients were more commonly diagnosed with unprovoked (n = 55; 57.4%) than provoked VTE (n = 39; 40.6%) (p = 0.03). A similar observation was made for ANAs titer ≥1: 320 (26 patients with unprovoked vs 20 patients with provoked VTE, p = 0.04). The presence of ANAs in the patient group did not correlate with age, sex, time since the VTE event, type of anticoagulation and its quality, inflammatory markers and D-dimer. The prevalence of positive ANAs was 5 times higher among VTE patients than in controls. Antinuclear antibodies occur commonly in VTE and might be involved in the pathogenesis of unprovoked VTE.

HLA-DR Allele Frequencies in Mexican Mestizos with Autoimmune Liver Diseases Including Overlap Syndromes

Autoimmune liver diseases are sometimes difficult to differentiate from hepatic overlap syndromes (OS). The objective of this study was to use polymorphic genetic markers to better distinguish clinical heterogeneity in autoimmune liver disease. Since autoimmunity is the result of autoantibody production we studied HLA-DR alleles in 20 patients with autoimmune hepatitis (AIH), 16 with primary biliary cirrhosis (PBC), 10 with OS, and in 99 ethnically matched healthy individuals. Patients with OS had significantly higher alkaline phosphatase and total bilirubin levels than patients with AIH. OS patients had a higher prevalence of positive antinuclear antibodies and a higher AIH score than patients with PBC. Patients with OS also had higher total immunoglobulin levels (IgG isotype) as compared to patients with PBC. We found in PBC patients a higher gene frequency of HLA-DR4 and DR1 as compared to healthy controls (p = 0.03, OR = 2.2 and p = 0.004, OR = 4.3, respectively) and to OS patients (p = 0.01, OR = 6.8, and p = 0.004, OR = 10.0, respectively). On the other hand, the gene frequency of HLADR5 was significantly decreased in the total group of patients as compared to healthy controls suggesting a protective role of this allele for developing autoimmune liver disease.

Antinuclear antibody is associated with a more advanced fibrosis and lower RNA levels of hepatitis C virus in patients with chronic hepatitis C

Aims:Positive serum antinuclear antibody (ANA) is present in a number of patients with chronic hepatitis C virus (HCV) infection. This study aimed to evaluate the prevalence of ANA in patients...

Lack of linkage between anti-nuclear antibody or clinical features of systemic lupus erythematosus (SLE) and TCR-A/Vbeta loci in families of subjects with SLE.

The role of the TCR-A and TCR-Vbeta genes in the genetic predisposition to SLE expression and anti-nuclear antibody (ANA) production were examined by linkage analysis in eighteen multiplex and forty-three simplex SLE families. All subjects were Caucasian. A significantly increased prevalence of positive ANAs in first-degree relatives of SLE patients from multiplex families was noticed compared to that of simplex families. Linkage between TCR-A/Vbeta genes and SLE expression and ANA production were analysed by affected sib-pair method. Results showed that the haplotypes identical by descent sharing TCR-A and TCR-Vbeta genes in the affected sib-pairs was not different from that expected (P = 0.93 and P = 0.74, respectively). There was no linkage between ANA positivity and TCR-A and TCR-Vbeta genes in ANA positive sib-pairs from both multiplex and simplex families. This study suggests that germline TCR-A and TCR-Vbeta gene loci confer no susceptibility to ANA and SLE expression.

Antinuclear Antibodies, Affective Disorders and Lithium Therapy

The prevalence of positive antinuclear antibody (ANA) was investigated in a group of patients suffering from recurrent affective disorders who had been treated for more than one year with lithium carbonate. There was no increase of ANA in these patients (8%) as compared with a group of patients suffering from affective disorders (7.5%), but untreated with lithium salts, or with the prevalence of ANA in the general population (9%) of the same age group.