Clinical usefulness of anti-nuclear antibody in childhood: real-world experience at a tertiary care center

We evaluated the reasons for requesting anti-nuclear antibody (ANA) analysis in clinical practice at a tertiary center and the performance of ANA in pediatric autoimmune diseases. Patients under 18 years of age who underwent ANA testing for various symptoms between 2013 and 2017 were included. We re...

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Bibliographic Details
Published in:European journal of pediatrics 2023-07, Vol.182 (7), p.3325-3335
Main Authors: Şahin, Nihal, Kısaarslan, Ayşenur Paç, Çiçek, Sümeyra Özdemir, Pınarbaşı, Ayşe Seda, Günay, Neslihan, Yel, Sibel, Dursun, İsmail, Poyrazoğlu, Muammer Hakan, Düşünsel, Ruhan
Format: Article
Language:English
Subjects:
Arthritis
Autoimmune diseases
Childhood
Children
Clinical medicine
Medical diagnosis
Medical records
Patients
Pediatrics
Regression analysis
Risk factors
Seroconversion
Systemic lupus erythematosus
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Summary:We evaluated the reasons for requesting anti-nuclear antibody (ANA) analysis in clinical practice at a tertiary center and the performance of ANA in pediatric autoimmune diseases. Patients under 18 years of age who underwent ANA testing for various symptoms between 2013 and 2017 were included. We retrieved data from medical records, including demographic and clinical characteristics, diagnoses, ANA results, titers, and staining patterns. The performance assessment tools were calculated according to the ANA titer for autoimmune diseases. Risk factors for autoimmune diseases in ANA-positive patients were evaluated using logistic regression analysis. Changes in ANA titer and seroconversion were evaluated using repeated ANA analyses. A total of 3812 patients underwent ANA. Medical records of 3320 patients were obtained. The rate of ANA positivity was 27.4%. ANA was requested most frequently because of musculoskeletal findings in 1355 patients (40.8%). Juvenile idiopathic arthritis (n = 174, 20.2%) was the most common diagnosis in ANA-positive patients, followed by systemic lupus erythematosus (n = 52, 6%). For autoimmune diseases, a titer of ≥ 1:100, a sensitivity of 40.1%, and a specificity of 77.1% were observed. At a titer ≥ 1:1000, the sensitivity and specificity were 24.1% and 89%, respectively. Homogeneous staining was an additional risk factor for autoimmune diseases in ANA-positive patients by multivariate logistic regression analysis (OR [95% CI]: 4.562 [3.076–6.766], p 
ISSN:0340-6199
1432-1076
DOI:10.1007/s00431-023-05017-w