Clinical features of 39 patients with antibodies to extractable nuclear antigens despite negative antinuclear antibodies

Evidence for autoimmunity including neurologic and connective tissue diseases

John Manley III Davis, Kevin G. Moder, Henry A. Homburger, Steven R Ytterberg

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Systemic lupus erythematosus (SLE) rarely presents with a negative antinuclear antibody (ANA). Although antibodies to extractable nuclear antigens (ENA) are sometimes ordered despite a negative ANA, it is unclear if this contributes to the diagnosis of SLE or other forms of connective tissue disease (CTD). We reviewed 39 patients with anti-ENA antibodies despite a negative ANA during a 1-year period to determine the presence of SLE or other CTD. Several patients had clinical features suggestive of CTD, including 1 with possible SLE. A number of patients had neurologic disorders, especially peripheral neuropathy. In this study, the finding of anti-ENA despite negative ANA was associated with neurologic disorders and CTD. This may represent test bias or false-positive anti-ENA assays or false-negative ANA assays, or may imply immune-related mechanisms not previously described.

Original languageEnglish (US)
Pages (from-to)208-217
Number of pages10
JournalMedicine
Volume84
Issue number4
DOIs
StatePublished - Jul 2005

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Nuclear Antigens
Connective Tissue Diseases
Antinuclear Antibodies
Autoimmunity
Nervous System
Systemic Lupus Erythematosus
Antibodies
Nervous System Diseases
Peripheral Nervous System Diseases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Clinical features of 39 patients with antibodies to extractable nuclear antigens despite negative antinuclear antibodies: Evidence for autoimmunity including neurologic and connective tissue diseases",
abstract = "Systemic lupus erythematosus (SLE) rarely presents with a negative antinuclear antibody (ANA). Although antibodies to extractable nuclear antigens (ENA) are sometimes ordered despite a negative ANA, it is unclear if this contributes to the diagnosis of SLE or other forms of connective tissue disease (CTD). We reviewed 39 patients with anti-ENA antibodies despite a negative ANA during a 1-year period to determine the presence of SLE or other CTD. Several patients had clinical features suggestive of CTD, including 1 with possible SLE. A number of patients had neurologic disorders, especially peripheral neuropathy. In this study, the finding of anti-ENA despite negative ANA was associated with neurologic disorders and CTD. This may represent test bias or false-positive anti-ENA assays or false-negative ANA assays, or may imply immune-related mechanisms not previously described.",
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