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Complement-fixing properties of antinuclear antibodies distinguish drug-induced lupus from systemic lupus erythematosus

Department of Molecular Genetics and Microbiology, University of New Mexico Medical School, Albuquerque, New Mexico, rlrubin{at}saiud.unm.edu

M Teodorescu

University of Illinois College of Medicine, Chicago, IL, USA, and TheraTest Laboratories, Inc., Lombard, IL, USA

E H Beutner

University at Buffalo, State University of New York and Beutner Laboratories, Inc., Buffalo, New York, USA

R W Plunkett

University at Buffalo, State University of New York and Beutner Laboratories, Inc., Buffalo, New York, USA

The immunofluorescence antinuclear antibody (ANA) test has been widely used to monitor autoimmune disease, but its value for diagnostic purposes is compromised by low specificity and high prevalence in disease-free individuals. The capacity of autoantibodies to fix serum complement proteins when bound to antigen is an important effector function because this property is associated with acute and chronic inflammatory processes. The current study evaluates the complement-fixing properties of antinuclear antibodies (CANA) in three well-defined and clinically-related patient groups: systemic lupus erythematosus (SLE), drug-induced lupus (DIL) and drug-induced autoimmunity (DIA). Of 20 patients diagnosed with SLE, 90% displayed complement-fixing ANA while this feature was present in only two of 18 patients with DIL and no patients with DIA without associated disease even though the mean ANA titres were similar among these patient groups. CANA was significantly correlated with anti-Sm activity. Because SLE but not DIL or DIA can be a life-threatening disease associated with complement consumption in vivo, these results demonstrate that measurement of CANA is a diagnostically useful tool and may have immunopathologic implications.

Key Words: complement-fixing antinuclear antibodies • drug-induced lupus • systemic lupus erythematosus

Lupus, Vol. 13, No. 4, 249-256 (2004)
DOI: 10.1191/0961203304lu1007oa


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