May Y Choi1, Ann E Clarke1, Yvan St Pierre2, John G Hanly3, Murray B Urowitz4, Juanita Romero-Diaz5, Caroline Gordon6, Sang-Cheol Bae7, Sasha Bernatsky2, Daniel J Wallace8, Joan T Merrill9, David A Isenberg10, Anisur Rahman10, Ellen M Ginzler11, Michelle Petri12, Ian N Bruce13, Mary A Dooley14, Paul R Fortin15, Dafna D Gladman4, Jorge Sanchez-Guerrero16, Kristjan Steinsson17, Rosalind Ramsey-Goldman18, Munther A Khamashta19, Cynthia Aranow20, Graciela S Alarcón21, Susan Manzi22, Ola Nived23, Asad A Zoma24, Ronald F van Vollenhoven25, Manuel Ramos-Casals26, Guillermo Ruiz-Irastorza27, S Sam Lim28, Kenneth C Kalunian29, Murat Inanc30, Diane L Kamen31, Christine A Peschken32, Soren Jacobsen33, Anca Askanase34, Thomas Stoll35, Jill Buyon36, Michael Mahler37, Marvin J Fritzler1. 1. University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada. 2. McGill University Health Centre, Montreal, Quebec, Canada. 3. Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada. 4. Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. 5. Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico. 6. University of Birmingham, Birmingham, UK. 7. Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea. 8. Cedars-Sinai/David Geffen School of Medicine at University of California Los Angeles. 9. Oklahoma Medical Research Foundation, Oklahoma City. 10. University College London, London, UK. 11. State University of New York Downstate Medical Center, Brooklyn. 12. Johns Hopkins University School of Medicine, Baltimore, Maryland. 13. Arthritis Research UK, University of Manchester, NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, and Manchester Academic Health Science Centre, Manchester, UK. 14. University of North Carolina, Chapel Hill. 15. CHU de Québec-Université Laval, Quebec City, Quebec, Canada. 16. Mount Sinai Hospital and University Health Network, University of Toronto, Toronto, Ontario, Canada. 17. Landspitali University Hospital, Reykjavik, Iceland. 18. Northwestern University and Feinberg School of Medicine, Chicago, Illinois. 19. St Thomas' Hospital and King's College, London School of Medicine, London, UK. 20. Feinstein Institute for Medical Research, Manhasset, New York. 21. University of Alabama at Birmingham. 22. Allegheny Health Network, Pittsburgh, Pennsylvania. 23. University Hospital Lund, Lund, Sweden. 24. Hairmyres Hospital, East Kilbride, Scotland, UK. 25. University of Amsterdam, Amsterdam, The Netherlands. 26. Hospital Clínic, Barcelona, Spain. 27. Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain. 28. Emory University School of Medicine, Atlanta, Georgia. 29. University of California San Diego School of Medicine, La Jolla. 30. Istanbul University, Istanbul, Turkey. 31. Medical University of South Carolina, Charleston. 32. University of Manitoba, Winnipeg, Manitoba, Canada. 33. Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 34. Hospital for Joint Diseases and New York University, New York. 35. Kantousspital, Schaffhausen, Switzerland. 36. New York University School of Medicine, New York. 37. Inova Diagnostics Inc., San Diego, California.
Abstract
OBJECTIVE: The spectrum of antinuclear antibodies (ANAs) is changing to include both nuclear staining as well as cytoplasmic and mitotic cell patterns (CMPs) and accordingly a change is occurring in terminology to anticellular antibodies. This study examined the prevalence of indirect immunofluorescence (IIF) anticellular antibody staining using the Systemic Lupus International Collaborating Clinics inception cohort. METHODS: Anticellular antibodies were detected by IIF on HEp-2000 substrate using the baseline serum. Three serologic subsets were examined: ANA positive (presence of either nuclear or mixed nuclear/CMP staining), anticellular antibody negative (absence of any intracellular staining), and isolated CMP staining. The odds of being anticellular antibody negative versus ANA or isolated CMP positive was assessed by multivariable analysis. RESULTS: A total of 1,137 patients were included; 1,049 (92.3%) were ANA positive, 71 (6.2%) were anticellular antibody negative, and 17 (1.5%) had an isolated CMP. The isolated CMP-positive group did not differ from the ANA-positive or anticellular antibody-negative groups in clinical, demographic, or serologic features. Patients who were older (odds ratio [OR] 1.02 [95% confidence interval (95% CI) 1.00, 1.04]), of white race/ethnicity (OR 3.53 [95% CI 1.77, 7.03]), or receiving high-dose glucocorticoids at or prior to enrollment (OR 2.39 [95% CI 1.39, 4.12]) were more likely to be anticellular antibody negative. Patients on immunosuppressants (OR 0.35 [95% CI 0.19, 0.64]) or with anti-SSA/Ro 60 (OR 0.41 [95% CI 0.23, 0.74]) or anti-U1 RNP (OR 0.43 [95% CI 0.20, 0.93]) were less likely to be anticellular antibody negative. CONCLUSION: In newly diagnosed systemic lupus erythematosus, 6.2% of patients were anticellular antibody negative, and 1.5% had an isolated CMP. The prevalence of anticellular antibody-negative systemic lupus erythematosus will likely decrease as emerging nomenclature guidelines recommend that non-nuclear patterns should also be reported as a positive ANA.
OBJECTIVE: The spectrum of antinuclear antibodies (ANAs) is changing to include both nuclear staining as well as cytoplasmic and mitotic cell patterns (CMPs) and accordingly a change is occurring in terminology to anticellular antibodies. This study examined the prevalence of indirect immunofluorescence (IIF) anticellular antibody staining using the Systemic Lupus International Collaborating Clinics inception cohort. METHODS: Anticellular antibodies were detected by IIF on HEp-2000 substrate using the baseline serum. Three serologic subsets were examined: ANA positive (presence of either nuclear or mixed nuclear/CMP staining), anticellular antibody negative (absence of any intracellular staining), and isolated CMP staining. The odds of being anticellular antibody negative versus ANA or isolated CMP positive was assessed by multivariable analysis. RESULTS: A total of 1,137 patients were included; 1,049 (92.3%) were ANA positive, 71 (6.2%) were anticellular antibody negative, and 17 (1.5%) had an isolated CMP. The isolated CMP-positive group did not differ from the ANA-positive or anticellular antibody-negative groups in clinical, demographic, or serologic features. Patients who were older (odds ratio [OR] 1.02 [95% confidence interval (95% CI) 1.00, 1.04]), of white race/ethnicity (OR 3.53 [95% CI 1.77, 7.03]), or receiving high-dose glucocorticoids at or prior to enrollment (OR 2.39 [95% CI 1.39, 4.12]) were more likely to be anticellular antibody negative. Patients on immunosuppressants (OR 0.35 [95% CI 0.19, 0.64]) or with anti-SSA/Ro 60 (OR 0.41 [95% CI 0.23, 0.74]) or anti-U1 RNP (OR 0.43 [95% CI 0.20, 0.93]) were less likely to be anticellular antibody negative. CONCLUSION: In newly diagnosed systemic lupus erythematosus, 6.2% of patients were anticellular antibody negative, and 1.5% had an isolated CMP. The prevalence of anticellular antibody-negative systemic lupus erythematosus will likely decrease as emerging nomenclature guidelines recommend that non-nuclear patterns should also be reported as a positive ANA.
Authors: Nancy Agmon-Levin; Jan Damoiseaux; Cees Kallenberg; Ulrich Sack; Torsten Witte; Manfred Herold; Xavier Bossuyt; Lucille Musset; Ricard Cervera; Aresio Plaza-Lopez; Carlos Dias; Maria José Sousa; Antonella Radice; Catharina Eriksson; Olof Hultgren; Markku Viander; Munther Khamashta; Stephan Regenass; Luis Eduardo Coelho Andrade; Allan Wiik; Angela Tincani; Johan Rönnelid; Donald B Bloch; Marvin J Fritzler; Edward K L Chan; I Garcia-De La Torre; Konstantin N Konstantinov; Robert Lahita; Merlin Wilson; Olli Vainio; Nicole Fabien; Renato Alberto Sinico; Pierluigi Meroni; Yehuda Shoenfeld Journal: Ann Rheum Dis Date: 2013-10-14 Impact factor: 19.103
Authors: M Y Choi; A E Clarke; Y St Pierre; J G Hanly; M B Urowitz; J Romero-Diaz; C Gordon; S-C Bae; S Bernatsky; D J Wallace; J T Merrill; D A Isenberg; A Rahman; E M Ginzler; M Petri; I N Bruce; M A Dooley; P Fortin; D D Gladman; J Sanchez-Guerrero; K Steinsson; R Ramsey-Goldman; M A Khamashta; C Aranow; G S Alarcón; S Manzi; O Nived; A A Zoma; R F van Vollenhoven; M Ramos-Casals; G Ruiz-Irastorza; S S Lim; K C Kalunian; M Inanc; D L Kamen; C A Peschken; S Jacobsen; A Askanase; J Buyon; M Mahler; M J Fritzler Journal: Lupus Date: 2017-02-23 Impact factor: 2.911
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Authors: Murray B Urowitz; Dafna D Gladman; Dominique Ibañez; Jorge Sanchez-Guerrero; Juanita Romero-Diaz; Caroline Gordon; Sang-Cheol Bae; Anne E Clarke; Sasha Bernatsky; Paul R Fortin; John G Hanly; David Isenberg; Anisur Rahman; Daniel J Wallace; Ellen Ginzler; Michelle Petri; Ian N Bruce; Joan T Merrill; Ola Nived; Gunnar Sturfelt; Mary Anne Dooley; Graciela S Alarcón; Barri Fessler; Kristjan Steinsson; Rosalind Ramsey-Goldman; Asad Zoma; Munther Khamashta; Susan Manzi; Ronald van Vollenhoven; Manuel Ramos-Casals; Cynthia Aranow; Thomas Stoll Journal: J Rheumatol Date: 2014-04-01 Impact factor: 4.666
Authors: Michele Compagno; Ole P Rekvig; Anders A Bengtsson; Gunnar Sturfelt; Niels H H Heegaard; Andreas Jönsen; Rasmus Sleimann Jacobsen; Gro Ø Eilertsen; Christopher G Fenton; Lennart Truedsson; Johannes C Nossent; Søren Jacobsen Journal: Lupus Sci Med Date: 2014-04-01
Authors: D Nikolopoulos; M Kostopoulou; A Pieta; T Karageorgas; D Tseronis; K Chavatza; S Flouda; P Rapsomaniki; A Banos; E Kremasmenou; V Tzavara; P Katsimbri; A Fanouriakis; D T Boumpas Journal: Lupus Date: 2020-02-27 Impact factor: 2.911
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