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Testing for anti-nucleosome antibodies in daily practice: a monocentric evaluation in 1696 patients

Service d’Immunochimie, Hôpital Pitié-Salpêtrière, Paris, France, pascale.ghillani-dalbin{at}psl.ap-hop-paris.fr

Z Amoura

Service de Médecine Interne, Hôpital Pitié-Salpêtrière, Paris, France

P Cacoub

Service de Médecine Interne, Hôpital Pitié-Salpêtrière, Paris, France

J-L Charuel

Service d’Immunochimie, Hôpital Pitié-Salpêtrière, Paris, France

M-C Diemert

Service d’Immunochimie, Hôpital Pitié-Salpêtrière, Paris, France

J-C Piette

Service de Médecine Interne, Hôpital Pitié-Salpêtrière, Paris, France

L Musset

Service d’Immunochimie, Hôpital Pitié-Salpêtrière, Paris, France

The objective was to report our experience of the detection of anti-nucleosome (anti-Nuc) antibodies (Ab) in a large series of consecutive patients, and to compare these results with those of anti-nuclear and anti-dsDNA Ab. In total, 1696 consecutive patients with suspected or confirmed autoimmune disease were tested over a two-year period. The biological investigation included detection of anti-nuclear, anti-dsDNA and anti-Nuc Ab. Among 1696 sera, 382 (23%) were negative for all Ab tested (anti-nuclear, anti-dsDNA and anti-Nuc) and 1314 (77%) were positive for at least one Ab. Anti-Nuc Ab were positive in 350/1314 patients. In this group, 249/350 (71%) also had positive anti-nuclear and anti-dsDNA, 97/350 (28%) had only positive anti-nuclear Ab without anti-dsDNA Ab and 4/350 (1%) had both anti-dsDNA and anti-Nuc Ab without anti-nuclear Ab. No patient had ‘isolated’ anti-Nuc Ab. Clinical data were available for 307/350 anti-Nuc positive patients. Systemic lupus erythematosus (SLE) was diagnosed in 240/307 (78%) patients, including 43 SLE patients with negative anti-dsDNA Ab. In conclusion, this study extends the relevance of anti-Nuc Ab to routine use for the diagnosis of connective tissue diseases, mainly anti-dsDNA Ab negative SLE.

Key Words: anti-dsDNA • anti-nuclear • anti-nucleosome • lupus

Lupus, Vol. 12, No. 11, 833-837 (2003)
DOI: 10.1191/0961203303lu475oa


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