Journal
LUPUS SCIENCE & MEDICINE
Volume 1, Issue 1, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/lupus-2013-000007
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Funding
- Danish Rheumatism Association
- Novo Nordisk Research Foundation
- Foundation for Health and Rehabilitation through the Norwegian Rheumatology Organisation [2004/2/0250]
- Northern Norway Regional Health Authority Medical Research Program [SFP-100-04, SFP-101-04]
- University of Tromso
- Swedish Rheumatic Patients' Association
- Foundation of King Gustaf V 80-year fund
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Despite anti-dsDNA antibodies constitute a wide range of specificities, they are considered as the hallmark for systemic lupus erythematosus (SLE). Objective: To identify clinical phenotypes associated with anti-dsDNA antibodies, independently of any clinical diagnoses. Methods: Patients with recent onset of any rheumatic symptoms were screened for antinuclear antibodies (ANA). All ANA-positive and matching ANA-negative patients were examined, and their clinical phenotypes were registered, using a systematic chart formulated after consensus between the participating centres. All patients were tested for different anti-dsDNA antibody specificities with assays habitually used in each participating laboratory. Crithidia Luciliae Immuno Fluorescence Test (CLIFT) was performed three times (with two different commercial kits); solid and solution phase ELISA were performed four times. Associations between clinical phenotypes and results of anti-dsDNA assays were evaluated by linear regression analysis (LRA) and principal component analysis (PCA). Results: Totally, 292 ANA-positive and 292 matching ANA-negative patients were included in the study. A full dataset for statistical analysis was obtained in 547 patients. Anti-dsDNA antibodies were most frequently detected by ELISA. LRA showed that overall positivity of anti-dsDNA antibodies was associated with proteinuria and pleuritis. Alopecia was significantly associated only with CLIFT-positivity. Besides confirming the same findings, PCA showed that combined positivity of CLIFT and ELISA was also associated with lymphopenia. Conclusions: Our results show that different anti-dsDNA antibody specificities are associated with nephropathy, pleuritis, alopecia and lymphopenia, regardless of the diagnosis. It may challenge the importance of anti-dsDNA antibodies as a diagnostic hallmark for SLE.
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