Current Concepts and Future Directions for the Assessment of Autoantibodies to Cellular Antigens Referred to as Anti-Nuclear Antibodies
Table 4
Clinical utility of ANA testing in different diseases.
Diagnosis
Clinical utility
ANA prevalence
Monitoring/prognosis
Comments
SLE
Very useful
90–95%
Not useful
ANA IIF superior to ANA solid phase assays
SSc
Very useful
85–95%
Not useful
ANA IIF superior to ANA solid phase assays
SjS
Useful
50–60%
Not useful
ANA solid phase assays superior to ANA IIF; SS-A reactivity can be missed by ANA HEp-2
AIM
Somewhat useful
50–60%
Not useful
ANA solid phase assays superior to ANA IIF; Jo-1 reactivity can be missed by ANA HEp-2
MCTD
Very useful
90–100%
Not useful
High titer anti-U1-RNP are highly indicative for MCTD
JCA/JIA
Somewhat useful
50–60%
Very useful
Useful for subset that are at risk of developing uveitis
PBC
Very useful
50–80%
Not proven
ANA IIF superior to solid phase assays; Antibodies to SP100, gp210, nucleoporin p62, lamin B receptor and Ro52 /TRIM21. Anti-gp210 reported association with poor prognosis.
RA
Not useful
15–20%
Not useful
Homogeneous and speckled staining are the most common patterns
APS
Not useful
40–70%
Not useful
Might indicate systemic autoimmunity in primary APS patients
AT
Not useful
10–20%
Not useful
Higher in Grave’s disease as compared to Hashimoto`s thyroiditis
Cancer and paraneoplastic syndromes
Not useful, or utility not established
20–50%
Not useful
Antibodies to CENP-F and to other proteins might be useful to help in the diagnosis of cancer; p53 has been discussed; not many systematic studies on ANA in cancer
