Clinical usefulness of anti-nuclear antibody in childhood: real-world experience at a tertiary care center Usefulness of ANA in pediatric autoimmune diseases

Şahin N., Kısaarslan A., Çiçek S. Ö., Pınarbaşı A. S., Günay N., Yel S., ...Daha Fazla

EUROPEAN JOURNAL OF PEDIATRICS, cilt.182, sa.7, ss.3325-3335, 2023 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 182 Sayı: 7
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1007/s00431-023-05017-w
  • Dergi Adı: EUROPEAN JOURNAL OF PEDIATRICS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE
  • Sayfa Sayıları: ss.3325-3335
  • Anahtar Kelimeler: Anti-nuclear antibody, Autoimmune disease, Diagnostic marker, Pediatric, Rheumatology
  • Erciyes Üniversitesi Adresli: Evet

Özet

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 < 0.001).Conclusion: Our results revealed that the performance of the ANA test in diagnosing autoimmune diseases in pediatric clinical practice was poor. Therefore, clinical findings should be carefully evaluated before ANA testing is performed.