The clinical spectrum of antinuclear antibodies associated with the nuclear dense fine speckled immunofluorescence pattern

• Published in: Journal of rheumatology 2005-11, Vol.32 (11), p.2144-2149
• Main Authors: DELLAVANCE, Alessandra, VIANA, Vilma S. T, LEON, Elaine P, BONFA, Eloisa S. D. O, ANDRADE, Luis E. C, LESER, Paulo G
• Format: Article
• Language: English
• Subjects: Adaptor Proteins, Signal Transducing - immunology; Antibodies, Antineutrophil Cytoplasmic - immunology; Antibodies, Antineutrophil Cytoplasmic - isolation & purification; Antibody Specificity; Biological and medical sciences; Carcinoma, Hepatocellular; Cell Nucleus - immunology; Diseases of the osteoarticular system; Endocrinopathies; Fluorescent Antibody Technique, Indirect - methods; HeLa Cells; Humans; Liver Neoplasms; Medical sciences; Miscellaneous. Osteoarticular involvement in other diseases; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Rheumatic Diseases - diagnosis; Rheumatic Diseases - immunology; Thyroid. Thyroid axis (diseases); Transcription Factors - immunology
• ISSN: 0315-162X; 1499-2752

OBJECTIVE: Autoantibodies to lens epithelium-derived growth factor (LEDGF) depict a distinctive nuclear dense fine speckled (DFS) pattern in the indirect immunofluorescence antinuclear antibody assay (IIF-ANA). Definition of the clinical spectrum associated with anti-LEDGF antibodies has been evolving over the last decade. We investigated the frequency, clinical spectrum, and immunologic specificity of the DFS pattern in a general clinical laboratory routine. METHODS. All serum samples entered for IIF-ANA determination within a 2 year period were examined for the DFS pattern. Positive samples with consistent clinical information were studied further by IIF with isotype-specific conjugate and immunoblot analysis. RESULTS: Among 13,641 ANA-positive samples, 5081 (37%) presented the DFS pattern. Within a 6 month nested period, there were 650 samples with DFS pattern, and consistent clinical data were available for 81 of these. DFS reactivity was mainly due to IgG. Most samples (86%) presented titer > or = 1/640. Eighty of the 81 DFS samples reacted with a 75 kDa band that comigrated with the band elicited by the standard anti-LEDGF serum. Antibodies that were affinity-purified from the 75 kDa band reproduced the DFS pattern on IIF-ANA. The clinical spectrum associated with DFS reactivity included autoimmune diseases (39%) and an array of nonautoimmune conditions (61%). Among the autoimmune patients, over half presented evidence of autoimmune thyroiditis. CONCLUSION: Anti-LEDGF/p75 antibodies are a common finding among ANA-positive individuals with no evidence of rheumatic autoimmune disease, and should be regarded as a low specificity finding even when in moderate or high titer.