Vol. 24 No. 1b (2024): Special Issue
Open Access
Peer Reviewed

Diagnostic Problem in Systemic Lupus Erythematosus: Ana Test and Other Immunologic Test

Authors

I Made Arya Yogiswara Mahayasa , Ayu Santia Dewi , Febry Gilang Tilana , Shafalyn Kalila Roliskana , I Gusti Bagus Surya Ari Kusuma , Lale Sirin Rifdah Salsabila , Indah Sapta Wardhani , Philip Habib

DOI:

10.29303/jbt.v24i1b.7912

Published:

2024-12-13

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Abstract

Systemic Lupus Erythematosus (SLE) is a complex chronic autoimmune disease that can affect multiple organ systems, with diverse clinical symptoms, disease course and prognosis. This study aims to evaluate the role of antinuclear antibody (ANA) tests and other immunologic tests in supporting the diagnosis of SLE, given the challenges in differentiating SLE from other autoimmune diseases. The method used was a literature review of relevant literature obtained through several databases, such as PubMed, Google Scholar, and ProQuest, which analyzed the accuracy and limitations of ANA tests and other immunological tests in supporting the diagnosis of SLE. The results show that the ANA test has high sensitivity but limited specificity, as positive ANA results can also be found in other autoimmune conditions or even in healthy individuals. Therefore, interpretation of ANA results should be done in the appropriate clinical context to optimize its diagnostic utility. In conclusion, ANA testing plays an important role in the evaluation of SLE and other ANA-related diseases, but should be combined with clinical evaluation and additional investigations to confirm or exclude the diagnosis.

Keywords:

Antinuclear antibody (ANA), diagnosis, predictive value, SLE, sensitivity, specificity.

References

Aringer, M., Costenbader, K., Daikh, D., Brinks, R., Mosca, M., Ramsey-Goldman, R., Smolen, J. S., Wofsy, D., Boumpas, D. T., Kamen, D. L., Jayne, D., Cervera, R., Costedoat-Chalumeau, N., Diamond, B., Gladman, D. D., Hahn, B., Hiepe, F., Jacobsen, S., Khanna, D., … Johnson, S. R. (2019). 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis and Rheumatology, 71(9), 1400–1412. https://doi.org/10.1002/art.40930

Chen, L., Welsh, K. J., Chang, B., Kidd, L., Kott, M., Zare, M., Carroll, K., Nguyen, A., Wahed, A., Tholpady, A., Pung, N., McKee, D., Risin, S. A., & Hunter, R. L. (2016). Algorithmic Approach with Clinical Pathology Consultation Improves Access to Specialty Care for Patients with Systemic Lupus Erythematosus. American Journal of Clinical Pathology, 146(3), 312–318. https://doi.org/10.1093/ajcp/aqw122

de Sá, A. C., Batista, M., Ferreira, A. L., Casanova, D., Faria, B., & Cotter, J. (2023). Diagnostic Challenges of Systemic Lupus Erythematosus. Cureus, 15(12). 10.7759/cureus.50132.

Davis, L. A., Goldstein, B., Tran, V., Keniston, A., Yazdany, J., Hirsh, J., Storfa, A., & Zell, J. (2015). Send Orders for Reprints to reprints@benthamscience.ae Applying Choosing Wisely: Antinuclear Antibody (ANA) and Sub-Serology Testing in a Safety Net Hospital System. In The Open Rheumatology Journal (Vol. 9).

Dima, A., Jurcut, C., & Baicus, C. (2018). The impact of anti-U1-RNP positivity: systemic lupus erythematosus versus mixed connective tissue disease. In Rheumatology International (Vol. 38, Issue 7, pp. 1169–1178). Springer Verlag. https://doi.org/10.1007/s00296-018-4059-4

Dinse, G. E., Parks, C. G., Weinberg, C. R., Co, C. A., Wilkerson, J., Zeldin, D. C., Chan, E. K. L., & Miller, F. W. (2020). Increasing Prevalence of Antinuclear Antibodies in the United States. Arthritis and Rheumatology, 72(6), 1026–1035. https://doi.org/10.1002/art.41214

Fanouriakis, A., Tziolos, N., Bertsias, G., & Boumpas, D. T. (2021). Update οn the diagnosis and management of systemic lupus erythematosus. Annals of the rheumatic diseases, 80(1), 14-25. 10.1136/annrheumdis-2020-218272.

Fanouriakis, A. et al. (2023) ‘EULAR recommendations for the management of systemic lupus erythematosus: 2023 update’, Annals of the Rheumatic Diseases, 83(1), pp. 15–29. doi: 10.1136/ard-2023-224762.

Fava, A. and Petri, M. (2020) ‘SLE: Diagnosis and clinical management’, Physiology & behavior, 176(3), pp. 139–148. doi: 10.1016/j.jaut.2018.11.001.Systemic.

Flechsig, A., Rose, T., Barkhudarova, F., Strauss, R., Klotsche, J., Dähnrich, C., Schlumberger, W., Enghard, P., Burmester, G.-R., Hiepe, F., Biesen, R., Flechsig, A., Rose, T., Barkhudarova, F., Strauss, R., Klotsche, J., Dähnrich, C., Schlumberger, W., Enghard, P., … Biesen, R. (2017). What is the clinical significance of anti-Sm antibodies in systemic lupus erythematosus? A comparison with anti-dsDNA antibodies and C3 Clinical significance of anti-Sm antibodies in SSS AA lechsig et all. In Clinical and Experimental Rheumatology (Vol. 35).

Irure-Ventura, J., & López-Hoyos, M. (2022). The Past, Present, and Future in Antinuclear Antibodies (ANA). In Diagnostics (Vol. 12, Issue 3). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/diagnostics12030647

Lam, N. V., Ghetu, M. V, & Bieniek, M. L. (2016). Systemic Lupus Erythematosus: Primary Care Approach to Diagnosis and Management (Vol. 94, Issue 4). www.aafp.org/afp.

Molina-Rios, S., Rojas-Martinez, R., Estévez-Ramirez, G. M., & Medina, Y. F. (2023). Systemic lupus erythematosus and antiphospholipid syndrome after COVID-19 vaccination. A case report. Modern Rheumatology Case Reports, 7(1), 43-46. 10.1093/mrcr/rxac018.

Nilsson, B. O., Skogh, T., Ernerudh, J., Johansson, B., Löfgren, S., Wikby, A., & Dahle, C. (2006). Antinuclear antibodies in the oldest-old women and men. Journal of Autoimmunity, 27(4), 281–288. https://doi.org/10.1016/j.jaut.2006.10.002

Rekvig, O. P. (2015). Anti-dsDNA antibodies as a classification criterion and a diagnostic marker for systemic lupus erythematosus: Critical remarks. Clinical and Experimental Immunology, 179(1), 5–10. https://doi.org/10.1111/cei.12296

Sammaritano, L. R. (2020) ‘Antiphospholipid syndrome’, Best Practice and Research: Clinical Rheumatology, 34(1), pp. 675–680. doi: 10.1016/j.berh.2019.101463.

Selvaraja, M., Too, C. L., Tan, L. K., Koay, B. T., Abdullah, M., Shah, A. M., ... & Amin-Nordin, S. (2022). Human leucocyte antigens profiling in Malay female patients with systemic lupus erythematosus: are we the same or different?. Lupus science & medicine, 9(1), e000554. 10.1136/lupus-2021-000554.

Sternhagen, E., Bettendorf, B., Lenert, A., & Lenert, P. S. (2022). The role of clinical features and serum biomarkers in identifying patients with incomplete lupus erythematosus at higher risk of transitioning to systemic lupus erythematosus: current perspectives. Journal of inflammation research, 1133-1145. 10.2147/JIR.S275043.

Stojan, G., & Petri, M. (2018). Epidemiology of systemic lupus erythematosus: An update. In Current Opinion in Rheumatology (Vol. 30, Issue 2, pp. 144–150). Lippincott Williams and Wilkins. https://doi.org/10.1097/BOR.0000000000000480

Tayem, M. G., Shahin, L., Shook, J., & Kesselman, M. M. (2022). A review of cardiac manifestations in patients with systemic lupus erythematosus and antiphospholipid syndrome with focus on endocarditis. Cureus, 14(1). 10.7759/cureus.21698.

Tsokos, G. C. (2020). Autoimmunity and organ damage in systemic lupus erythematosus. In Nature Immunology (Vol. 21, Issue 6, pp. 605–614). Nature Research. https://doi.org/10.1038/s41590-020-0677-6

Wei, P., Li, C., Qiang, L., He, J., Li, Z., & Hua, H. (2015). Role of salivary anti-SSA/B antibodies for diagnosing primary Sjögren’s syndrome. Medicina Oral, Patologia Oral y Cirugia Bucal, 20(2), e156–e160. https://doi.org/10.4317/medoral.20199

Yang, F., He, Y., Zhai, Z., Sun, E., & Guan, Q. (2019). Programmed Cell Death Pathways in the Pathogenesis of Systemic Lupus Erythematosus. In Journal of Immunology Research (Vol. 2019). Hindawi Limited. https://doi.org/10.1155/2019/3638562

Zhang, L., Yin, L., Lv, W., Wang, Y., Liu, Y., Gou, C., Hu, J., & Wang, X. (2023). Clinical analysis of patients with systemic lupus erythematosus complicated with liver failure. Clinical Rheumatology, 42(6), 1545–1553. https://doi.org/10.1007/s10067-023-06524-9

Zhou, Z., Wang, F., Sun, Y., Teng, J., Liu, H., Cheng, X., ... & Ye, J. (2022). Correspondence on ‘EULAR recommendations for the management of antiphospholipid syndrome in adults’. Annals of the Rheumatic Diseases, 81(12), e248-e248. 10.1136/annrheumdis-2020-218950

Author Biographies

I Made Arya Yogiswara Mahayasa, Universitas Mataram

Author Origin : Indonesia

Ayu Santia Dewi, Universitas Mataram

Author Origin : Indonesia

Febry Gilang Tilana, Universitas Mataram

Author Origin : Indonesia

Shafalyn Kalila Roliskana, Universitas Mataram

Author Origin : Indonesia

I Gusti Bagus Surya Ari Kusuma, Universitas Mataram

Author Origin : Indonesia

Lale Sirin Rifdah Salsabila, Universitas Mataram

Author Origin : Indonesia

Indah Sapta Wardhani, Universitas Mataram

Author Origin : Indonesia

Philip Habib, Universitas Mataram

Author Origin : Indonesia

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How to Cite

Mahayasa, I. M. A. Y., Dewi, A. S., Tilana, F. G., Roliskana, S. K., Kusuma, I. G. B. S. A., Salsabila, L. S. R., … Habib, P. (2024). Diagnostic Problem in Systemic Lupus Erythematosus: Ana Test and Other Immunologic Test. Jurnal Biologi Tropis, 24(1b), 296–302. https://doi.org/10.29303/jbt.v24i1b.7912

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