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Autoantibody (AAb) Profile, with special reference to ENA, in Indian (Asian) patients with connective tissue disorders (CTD).

ANURADHA VENUGOPALAN, CHOPRA ARVIND, STURGESS A, EDMONDS J.
CENTER FOR RHEUMATIC DISEASES, PUNE. THE ST. GEORGE HOSPITAL, SYDNEY.

In our setting, ENA testing facilities are sparse.

Funded by APLAR Laboratory Fellowship - 1999


Aim


AAb profile, especially ENA, in patients of CTD.

Methods


81 successive patients of CTD, some under treatment at a rheumatology referal practice clinic in western Maharashtra (India), [SLE = 34; PSS = 8; MCTD = 6; Myositis = 8; unclassifiable CTD (CTD-U) = 25] were selected and classified as per ACR; primary vasculitis excluded. ANA (indirect immunofluorescence using HEp 2), dsDNA (Farr Technique) and ENA (CIEP using guinea pig kidney and rabbit thymus extract) were tested. If available, medical records were reviewed for past AAb results.

Results


80% patients were positive for ANA (SLE: 94%; PSS: 100%; MCTD: 100% Myositis : 86%; CTD-U : 48%). Anti dsDNA was found in 31% patients (SLE: 65%; PSS: 25%; MCTD:50%; Myositis:13% CTD-U:12%) Antibodies to ENA was detected in 56% patients(SLE:74%; PSS:75%; MCTD:100%; Myositis:13% CTD-U:28%). All ENA seropositives were further characterized. The results are as follows:
 
 
SLE (N=25)
N (%)
PSS(N=6)
N (%)
MCTD(N=6)
N (%)
CTD-U(N=25)
N (%)
Sm
6 (24)
1(17)
1(17)
3(12)
RNP
5(20)
2(33)
3(50)
3(12)
SS-A
15(60)
1(17)
3(50)
5(20)
SS-B
5(20)
1(17)
2(33)
1(4)
rRNP
4(16)
0(0)
0(0)
1(4)
Scl-70
0(0)
3(50)
0(0)
0(0)
 

Conclusions


The Indian CTD AAb profile is rather similar to caucasian data. The lesser frequency of anti dsDNA in SLE (?therapy effect) needs further probe. ENA Ab may aid diagnosis in some cases of CTD-U.

CENTER FOR RHEUMATIC DISEASES (CRD)
Hermes Doctor House, Hermes Elegance, Convent Street, Camp, Pune – 411 001, Maharashtra, India.
Tel:
020-26348529, 26345624, 26344099