Evidence map›Paper›PMID 37016193›Full record

ArticleClinical rheumatology2023

Negative ANA-IIF in SLE patients: what is beyond?

Hanan Sayed M Abozaid, Hesham M Hefny, Esam M Abualfadl, Mohamad A Ismail, Amal K Noreldin, Ahmed N Nour Eldin, Asmaa M Goda, Amal H Ali

Open access · hybridAbstract read
In one paragraph

Article in Clinical rheumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Hanan Sayed M AbozaidRheumatology & Rehabilitation Department, Sohag Faculty of Medicine, Sohag University Hospital, Sohag, 82524, Egypt. hanan72eg@yahoo.com.ORCID http://orcid.org/0000-0003-1601-2578
Hesham M HefnyClinical Pathology Department, Sohag University Hospital, Sohag, Egypt.
Esam M AbualfadlRheumatology & Rehabilitation Department, Sohag Faculty of Medicine, Sohag University Hospital, Sohag, 82524, Egypt.
Mohamad A IsmailRheumatology & Rehabilitation Department, Sohag Faculty of Medicine, Sohag University Hospital, Sohag, 82524, Egypt.
Amal K NoreldinInternal Medicine Department, Sohag University Hospital, Sohag, Egypt.
Ahmed N Nour EldinInternal Medicine Department, Sohag University Hospital, Sohag, Egypt.
Asmaa M GodaMedical Microbiology and Immunology, Faculty of Medicine, Sohag University, Sohag, Egypt.
Amal H AliMedical Microbiology and Immunology, Faculty of Medicine, Aswan University, Aswan, Egypt.
Sohag University · EGAswan University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The antinuclear antibody (ANA) test has high sensitivity in diagnosing and classifying systemic lupus erythematosus (SLE).

objectivesTo describe the immunological pattern of SLE patients through investigating specific antinuclear autoantibodies by enzyme dot immunoassay and studying their frequency in both positive and negative ANA indirect immunofluorescence assay (IIF) cases.

methodsIn a cross-sectional study, blood samples from 393 newly diagnosed SLE patients were analyzed using (IIF) on HEp-2 cells and ANA dot immunoassay by automated enzyme immunoassay (EIA) to detect 19 antibodies.

resultsNinety-one percent of the patients are females; their mean age was 37 ± 12.28. Antinuclear antibody (ANA) was detected by IIF in 82.4% of cases, with 181 (46.1%) speckled and 167 (42.4%) homogeneous ANA patterns. The majority of patients (96%) demonstrated autoantibodies via EIA. Among the ANA-IIF-negative patients, 97.2% demonstrated autoantibodies. There was a significant difference in the frequency of certain autoantibodies between SLE patients with negative and positive ANA-IIF (1.44 0.73, 3.12 2.09, p = 0.00) respectively.

conclusionThe results of analyzing 19 autoantibodies with the ANA staining pattern increased the significance of analyzing the immune profile even if IIF is negative when clinical symptoms strongly suggest SLE diagnosis. Certain autoantibodies may evade staining by the IFA approach while they are present in the patient's serum, and they may not be detected by the ANA EIA profile if it does not contain that antigenic substrate. Key Points • Indirect immunofluorescence on Hep-2 is the conventional method for ANA detection and is regarded as the "gold standard" for testing in clinical practice for SLE. • In our study, ANA profile dot enzyme immunoassay (EIA)-based test was performed to evaluate 19 autoantibodies in SLE patients either positive or negative for ANA-IIF. • The presence of anti-dsDNA with ANA-IIF-negative serum in 32.4% of SLE patients provides evidence that not all anti-dsDNA antibodies are identified on standard HEp-2 substrates. • certain autoantibodies can evade staining by the ANA-IIF method despite being present in the SLE patient's blood; this supports the ANA profile enzyme dot immunoassay as a more sensitive test.

Indexed as

Antibodies, AntinuclearLupus Erythematosus, SystemicAdultAutoantibodiesCross-Sectional StudiesFemaleFluorescent Antibody Technique, IndirectHumansMaleMiddle AgedYoung AdultAntibodies, AntinuclearAutoantibodiesANA EIAANA-IIFSLE

Identifiers

PMID37016193
PMCPMC10267001
OpenAlexW4362601173

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.