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- W197169283 abstract "Nos objectifs étaient de déterminer la pertinence clinique et la signification diagnostique des anticorps antinucléaires (AAN) de spécificité antigénique indéterminée par les techniques de typage usuelles. Étude rétrospective menée dans le laboratoire d’immunologie du CHU Habib Bourguiba de Sfax sur 18 mois. Les critères d’inclusion étaient un titre d’AAN supérieur ou égal à 1/320 avec typage négatif. Le dépistage des AAN était réalisé par immunofluorescence indirecte (IFI) sur cellules Hep2 et chaque sérum positif était testé par IFI sur Crithidia luciliae (anti-AND natif) et par immunodot (anti-nucléosome, anti-histones, anti-Sm, anti-RNP, anti-SSA, anti-SSB, anti-Scl 70, anti-PM-Scl, anti-Jo1, anti-PCNA et anti-ribosomes). Après consultation des dossiers, les sérums des patients atteints de lupus érythémateux systémique (LES), de myosite ou de sclérodermie étaient retestés pour les anti-Ku, anti-PL7, anti-PL12 and anti-Ro-52 en utilisant un dot myositis. Quatre-vingt-dix cas ont été étudiés : 18 hommes et 72 femmes (âge moyen : 44 ans). La notion de prise médicamenteuse inductrice d’AAN était retrouvée chez huit patients. Les signes cliniques les plus fréquents étaient articulaires (56,7 %), cutanés (54,4 %) et généraux (45,6 %). Le diagnostic de maladie auto-immune (MAI) était évoqué chez 49 patients (54,5 %) et retenu chez 30 (33,3 %) dont 20 cas de connectivites : myosites (n = 6), sclérodermie (n = 5), syndrome de Gougerot-Sjögren (n = 3), LES (n = 4), polyarthrite rhumatoïde (PR) (n = 6) et syndrome des antiphospholipides (n = 4). Les autres MAI étaient moins fréquentes. Le dot myositis a détecté des anti-Ku chez la majorité des patients porteurs de connectivites. Le diagnostic de maladie non auto-immune était établi chez 25,5 % des patients. Dix-huit patients (20 %) n’avaient pas d’orientation diagnostique. Notre étude montre l’intérêt diagnostique des AAN même en l’absence de spécificité antigénique connue, confirme la place de l’IFI comme examen de référence pour la recherche d’AAN et, enfin, suggère l’intérêt de l’intégration de l’antigène Ku dans le profil classique de l’immunodot. The objective of this study was to determine the clinical relevance and the diagnostic significance of positive antinuclear antibodies (ANA) without identified antigenic target by the usual characterization technique. Retrospective study conducted in the Laboratory of Immunology of Habib Bourguiba Hospital (Sfax, Tunisia) during 18 months. The inclusion criteria were the presence of an ANA titer greater or equal to 1/320 with negative characterization result. ANA screening was performed by indirect immunofluorescence (IIF) on Hep2 cells. Each positive serum was tested by IIF on Crithidia luciliae (anti-native DNA) and by immunodot (anti-nucleosome, anti-histone, anti-Sm, anti-RNP, anti-SSA, anti-SSB, anti-Scl 70, anti-PM-Scl, anti-Jo1, anti-PCNA and anti-ribosomal protein). Sera of systemic lupus erythematosus (SLE), myositis, and scleroderma patients were tested for anti-Ku, anti-PL7, anti-PL12 and anti-Ro-52 using dot myositis. Sera of 90 patients were studied: 18 men and 72 women (average age: 44 years). Drug-induced ANA was found in eight patients. The most frequent clinical symptoms were joint (56.7%), cutaneous (54.4%) and constitutional symptoms (45.6%). The diagnosis of an autoimmune disease was suspected in 49 patients (54.5%) and confirmed in 30 (33.3%) including 20 cases of connective tissue disease: myositis (n = 6), scleroderma (n = 5), Sjögren's syndrome (n = 3), SLE (n = 4), rheumatoid arthritis (n = 6) and antiphospholipid syndrome (n = 4). Other autoimmune diseases were less frequent. The anti-Ku antibody was detected in the majority of patients with connective tissue disease. The diagnosis of non-autoimmune diseases was established in 25.5% of patients. Eighteen patients (20%) had no diagnosis orientation. Our study demonstrated the diagnostic value of the presence of ANA even in the absence of known antigenic target, confirmed the role of the IIF as “gold standard” test for ANA screening, and suggested the usefulness of the addition of Ku antigen in the immunodot classic profile." @default.
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- W197169283 date "2012-09-01" @default.
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- W197169283 title "Prévalence et valeur diagnostique des anticorps antinucléaires de spécificité antigénique indéterminée : étude rétrospective à propos d’une série de 90 patients" @default.
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- W197169283 doi "https://doi.org/10.1016/j.revmed.2012.04.017" @default.
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