Systemic lupus erythematosus (SLE) is an autoimmune disease produces autoantibodies against nuclear antigens (ANA), characterized by diverse clinical presentations. The presence of ANA is the most sensitive test for diagnosing SLE. The aim of this study was to compare the diagnostic performance for SLE of enzyme- linked immunosorbent assay (ELISA) and indirect immunofluorescence assay (IFA). Determination of out whether ANA patterns and ANA levels might reflect the level of disease activity was also investigated.
We tested the ANA in 77 patients with SLE and 16 healthy controls served as a control group. Clinical disease activity was scored according to Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. The moderate agreement between ELISA and IFA determined by the k statistic (P < 0.001) and the disparities between both ELISA-positive/IFA-negative samples and IFA-positive/ELISA negative were found. IFA (The positive likelihood ratio (+LR) = +infinity) performed better than the ELISA (+LR = 11.22) for the diagnosis of SLE at the manufacturer's cut off. IFA was also the best at distinguishing patients with active and inactive disease using manufacturer's cut off (p = 0.036). IFA was the best global test to screening ANA for both diagnosis and disease activity evaluation in SLE.
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2022: 6.012
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