Antinükleer Antikor Pozitif Hastalarda Test İsteme Nedenleri ve Hastaların Nihai Tanıları

Abstract

Background: The aim of this study was to determine the reasons for the request for antinuclear antibody (ANA) in ANA-positive patients and to determine the final diagnosis of these patients and whether they developed a rheumatologic disease. Method: In this retrospective study, the files of 559 patients with positive ANA were reviewed. Demographic, laboratory and clinical characteristics of the patients were noted. At the end of follow-up, the final diagnosis was recorded. Results: The study included 346 patients. 233 of the patients were female, and 113 were male. The mean age at the time of ANA positivity was 9.4  4.7 years, and the mean follow-up period was 19  5.7 months. The most common symptom was myalgia/arthralgia (21.7%). Other common reasons were urticaria, abdominal pain, thrombocytopenia, and proteinuria. Extractable nuclear antigens (ENA) panel results were negative in 170 patients (49.1%). In the ENA panel, dense fine speckled antigen 70 antibodies were most frequently positive in 135 patients (39.2%). At the end of follow-up, 234 patients had no disease. One hundred and one patients were diagnosed with non-rheumatologic diseases, and 11 patients were diagnosed with rheumatologic diseases. Eleven patients with rheumatologic diseases were girls. Rash was the most common symptom in patients with rheumatologic diseases. The positive predictive value of ANA positivity for rheumatologic disease was 3.2% and 1.7% for systemic lupus erythematosus. Conclusions: Due to the low positive predictive value of ANA testing, patients at risk for autoimmune diseases should be identified and carefully evaluated before ANA is requested.