Antinuclear Antibody Assessment Essay - 885 Words

Background to Antinuclear Antibody Testing The detection of autoantibodies against intracellular targets called antinuclear antibodies (ANA) is important in the diagnosis of systemic autoimmune rheumatic diseases (SARD) such as systemic lupus erythematosus (SLE), Sjà ¶grens syndrome (SjS), mixed connective tissue diseases (MCTD), systemic sclerosis (SSc) and idiopathic inflammatory myopathies (IIM). Testing for ANA is therefore a logical first step in the differential evaluation of patients when systemic autoimmune etiology is suspected. Timely diagnosis of SARD is challenging due to the wide spectrum of overlapping symptoms. Furthermore, while the frequency of ANA is highest in patients with SARD, these antibodies are also found in†¦show more content†¦Thus, testing for ANA or ANA-specific autoantibodies have been incorporated in a number diagnostic criteria. For example, a positive ANA finding was incorporated as a diagnostic criterion for SLE [18, 19]. In 2013, a joint committee of the American College of Rheumat ology (ACR) and the European League Against Rheumatism (EULAR) formulated a new set of SSc classification criteria which included the ANA-specific autoantibodies, namely; anti-topoisomerase I (anti-topo I or anti-Scl-70), anti-centromere (ACA), and anti-RNA polymerase III (anti-RNAP III [20]. Indications for Antinuclear Antibody Testing ANA testing is commonly used to assess the likelihood of a diagnosis of SARD where relevant information comes from the identification of antibodies bound to specific intracellular targets. While the immunological mechanisms underlying these interactions are poorly understood, the presence of ANA generally represents abnormal responses to self-antigens, a key feature of autoimmunity. In routine clinical laboratory evaluation, ANA are generally categorized based on the recognition of the homogeneous, speckled, centromere and nucleolar patterns [1, 2, 15-17]. While some ANA are used as part of diagnostic for SARD, e.g. SLE, MCTD, and SjS, their presence may also serve as an important diagnostic support for others (SSc, IIM, secondary SjS, and juvenile arthritis). The recognition of a well-defined ANA staining pattern using the HEp-2 cell substrate may be helpful inShow MoreRelatedPodiatry Rhuematoid Arthritis8124 Words   |  33 Pages Introduction Throughout this essay I shall critique the available evidence regarding rheumatoid arthritis (RA); particularly concerning the conclusions on its aetiology, diagnosis techniques, pharmacological management, physical therapeutics and surgical treatment interventions. I shall explore the expected prognosis and the key developments we can expect in the future. Aetiology and Prevalence RA is a chronic, systemic and inflammatory disease that progressively impacts peripheral joints