Division of Pediatric Rheumatology, Department of Pediatrics, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Turk J Med Sci. 2023 Feb;53(1):193-198. doi: 10.55730/1300-0144.5572. Epub 2023 Feb 22.
Antinuclear antibody (ANA) is among the most frequently ordered tests in paediatric rheumatology setting. Diseases like systemic lupus erythematosus and Sjögren syndrome is closely related with a positive ANA and classified as ANA associated diseases. Besides, ANA test is ordered in patients with juvenile idiopathic arthritis (JIA) to assess the risk for uveitis and a positive ANA could be detected in children with nonrheumaticrheumatic conditions. In this study, we aimed to investigate frequency of positive ANA in paediatric rheumatology setting and the association of immunofluorescence staining patterns and titres of ANA with rheumatic diseases.
: Immunofluorescence staining patterns, and titres of the ANA and diagnoses of children who tested for ANA between January 2016 and December 2021 were retrospectively analysed.
Among 2477 patients with ANA tested, 28.1% had a positive ANA result. Among them, 39.2% had a diagnosis of a rheumatic disease. Most common rheumatic diagnosis was JIA (43.8%) and ANA associated diseases were observed in 24.5% of the patients with a rheumatic diagnosis. While ANA associated diseases had significantly more frequent homogenous staining, dense fine speckled pattern was significantly more common in children with nonrheumatic diagnoses. Despite ANA associated diseases was found to be significantly associated with higher titres, no difference was observed between patients with JIA and nonrheumatic conditions.
Our study showed that the majority of children with a positive ANA test were not diagnosed with a rheumatic disease. While titres and patterns of ANA were found to be important in diagnosis of rheumatic diseases, ordering ANA test with solid indications might give improved probability of rheumatic diagnoses in children with a positive test.
抗核抗体（ANA）是儿科风湿病学中最常检测的项目之一。红斑狼疮和干燥综合征等疾病与 ANA 阳性密切相关，被归类为 ANA 相关疾病。此外，ANA 检测也用于青少年特发性关节炎（JIA）患者，以评估虹膜炎的风险，非风湿性疾病的儿童也可能检测出 ANA 阳性。本研究旨在调查儿科风湿病学中 ANA 阳性的频率，以及免疫荧光染色模式和 ANA 滴度与风湿病的关系。
回顾性分析 2016 年 1 月至 2021 年 12 月间检测 ANA 的儿童的免疫荧光染色模式、ANA 滴度和诊断。
在 2477 例检测 ANA 的患者中，28.1%的患者 ANA 阳性。其中，39.2%的患者诊断为风湿病。最常见的风湿病诊断是 JIA（43.8%），ANA 相关疾病在有风湿病诊断的患者中占 24.5%。虽然 ANA 相关疾病的均质染色明显更常见，但在非风湿性诊断的儿童中，致密细颗粒状模式更为常见。尽管 ANA 相关疾病与更高的滴度显著相关，但 JIA 患者与非风湿性疾病患者之间没有差异。
本研究表明，大多数 ANA 阳性检测的儿童并未诊断为风湿病。虽然 ANA 滴度和模式在风湿病的诊断中很重要，但在有明确适应证的情况下检测 ANA 可能会提高阳性检测儿童的风湿病诊断率。
