The clinical relevance of anti-dsDNA antibodies determined by the Elia™ dsDNA assay in patients with negative indirect immunofluorescence on the HEp-2 cell

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Christoph Robier ◽  
Maximiliane Haas ◽  
Franz Quehenberger
Keyword(s):  
Indirect Immunofluorescence ◽  
Lupus Erythematosus ◽  
Medical Records ◽  
Clinical Relevance ◽  
Solid Phase ◽  
Clinical Importance ◽  
Discoid Lupus Erythematosus ◽  
Combined Use ◽  
Significant Difference ◽  
Dsdna Antibodies

AbstractObjectivesData on the clinical importance of the detection of anti-dsDNA antibodies in patients with negative indirect immunofluorescence on the HEp-2 cell (IIF) are sparse and are especially not available for all common commercially available assays. This study aimed to assess the clinical significance of anti-dsDNA antibodies determined by the Elia™ dsDNA assay in patients with negative IIF.MethodsWe retrospectively examined the medical records of 234 consecutive subjects with detectable anti-dsDNA antibodies determined by the Elia™ dsDNA assay.ResultsA total of 124 subjects with detectable anti-dsDNA autoantibodies were IIF-negative, but yielded positive or borderline results in the Elia™ CTD screen assay for antinuclear antibodies (ANA). Within this group, 6/49 IIF-negative patients (12%) with ANA-associated systemic autoimmune rheumatic disorders (AASARD) and 118/185 subjects (64%) with various other diseases (Non-AASARD) were identified. There was no statistically significant difference with regard to the concentrations of anti-dsDNA antibodies (p=0.53) between the AASARD and the Non-AASARD group. Within the AASARD group, four patients diagnosed with systemic lupus erythematosus (SLE, treated), discoid lupus erythematosus (untreated), indetermined connective tissue disease (untreated) and polymyositis (treated) had positive anti-dsDNA autoantibodies, whereas two patients with treated SLE, thereby one in remission, had borderline concentrations of anti-dsDNA antibodies.ConclusionsOur findings suggest that the detection of anti-dsDNA antibodies in IIF-negative patients can be of clinical relevance in some cases. Our results further support the combined use of IIF and solid-phase assays in screening algorithms for ANA, in order to avoid overlooking potentially important autoantibody entities.

DNA mobility shift assay as a tool for the detection of anti-dsDNA antibodies in sera from discoid lupus erythematosus patients

2012 ◽  
Vol 39 (7) ◽  
pp. 602-607 ◽  
Author(s):  
Jacqueline KEYHANI ◽  
Mashallah AHADI ◽  
Ezzatollah KEYHANI ◽  
Zahra NARAGHI ◽  
Safar SHAMOHAMMADI
Keyword(s):  
Lupus Erythematosus ◽  
Discoid Lupus Erythematosus ◽  
Mobility Shift ◽  
Dna Mobility ◽  
Mobility Shift Assay ◽  
Dsdna Antibodies

Comparison of Psychiatric Disorders Between Levetiracetam Combined With Lacosamide and Perampanel

2021 ◽  
Author(s):  
Satoru Matsunuma ◽  
Shigeki Sunaga ◽  
Akira Hoshiai ◽  
Takao Arai ◽  
Hiroyuki Jimbo ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Antiepileptic Drugs ◽  
Medical Records ◽  
Medical Center ◽  
Combined Use ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patients With Epilepsy ◽  
Time To Onset ◽  
Dose Dependent

Abstract Background The number of patients with epilepsy receiving perampanel or lacosamide as an add-on treatment following levetiracetam treatment has increased. Although levetiracetam causes psychiatric disorders, it is unclear whether they occur with the combined use of these antiepileptic drugs.Objective To determine the frequency of psychiatric disorders in patients using lacosamide or perampanel as an add-on therapy to levetiracetam. Setting A single-center retrospective cohort study. Methods Patients who received levetiracetam, lacosamide, and perampanel between April 1, 2014 and April 30, 2019 in Hachioji Medical Center were selected. They were classified into the levetiracetam+lacosamide or levetiracetam+perampanel group. Medical records from the start of combination therapy contained patient background and the incidence of psychiatric disorders. Main outcome measure Onset of psychiatric disorders. Results Forty-four patients used levetiracetam+lacosamide and 50 used levetiracetam+perampanel. The incidence of psychiatric disorders was significantly lower (p = 0.000047) with levetiracetam+lacosamide (6.8%) than with levetiracetam+perampanel (46%). The time to the onset of psychiatric disorders was within 1 month of dose initiation or increase in one case (33.3%) with levetiracetam+lacosamide and 16 cases (76.2%) with levetiracetam+perampanel. The median time to onset was 56 and 6.5 days with levetiracetam+lacosamide and levetiracetam+perampanel, respectively. There was no significant difference in antiepileptic drug dosages owing to the presence or absence of psychiatric disorders. Conclusion As the frequency of psychiatric disorders was higher with levetiracetam+perampanel therapy, levetiracetam+lacosamide may be preferable. These disorders tended to develop within 1 month of therapy and were not dose-dependent. Antiepileptic drugs should be cautiously prescribed to avoid psychiatric disorders.

Ophthalmic disorders in a referral population of seven breeds of brachycephalic dogs: 970 cases (2008–2017)

2021 ◽  
pp. 1-7
Author(s):  
Samantha V Palmer ◽  
Filipe Espinheira Gomes ◽  
Jessica A. A. McArt
Keyword(s):  
Teaching Hospital ◽  
Medical Records ◽  
Clinical Relevance ◽  
Keratoconjunctivitis Sicca ◽  
Corneal Ulcers ◽  
Anatomic Location ◽  
Significant Difference ◽  
Study Population ◽  
Ophthalmic Diseases

Abstract OBJECTIVE To evaluate the frequency of ophthalmic disorders in 7 brachycephalic dog breeds referred to an academic veterinary ophthalmology service. ANIMALS 970 client-owned dogs of 7 brachycephalic breeds that were evaluated by the ophthalmology service in a veterinary teaching hospital from January 2008 through December 2017. PROCEDURES Medical records of 7 brachycephalic breeds (ie, Boston Terriers, English Bulldogs, French Bulldogs, Lhasa Apsos, Pekingese, Pugs, and Shih Tzus) were reviewed to collect data regarding patient signalment, ophthalmic diagnoses, affected eyes, and number and dates of visits. RESULTS Median age at the first examination was 7 years (range, 23 days to 22 years). The number of dogs seen for a first examination increased with age. Corneal ulcers, keratoconjunctivitis sicca, corneal pigmentation, immature cataracts, and uveitis were each diagnosed in ≥ 100 dogs and represented 40.4% (1,161/2,873) of all diagnoses. On the basis of anatomic location, 66.3% (1,905/2,873) of all disorders were located in either the cornea (1,014/2,873 [35.2%]) or adnexa (891/2,873 [31%]). There was a significant difference in breed proportion in the study population; of the 7 breeds studied, Shih Tzus (34.3% [333/970]), Pugs (20.8% [202/970]), and Boston Terriers (16.6% [161/970]) were the most prevalent breeds. The frequency of some diseases within the referral population was associated with breed. CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that the most prevalent disorders for the brachycephalic breeds in this ophthalmic referral population were corneal ulcers, keratoconjunctivitis sicca, corneal pigmentation, immature cataracts, and uveitis. Although all dogs shared brachycephalic features, the frequency of specific ophthalmic diseases varied between breeds.

scholarly journals High Prevalence of Metabolic Syndrome in Patients with Discoid Lupus Erythematosus: A Cross-Sectional, Case-Control Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Sevgi Akarsu ◽  
Ozlem Ozbagcivan ◽  
Fatma Semiz ◽  
Sebnem Aktan
Keyword(s):  
Metabolic Syndrome ◽  
Lupus Erythematosus ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Discoid Lupus Erythematosus ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Impact ◽  
Control Study

Although it is known that systemic form of lupus erythematosus (LE) and metabolic syndrome (MetS) are frequently observed together, there are no published reports on MetS in patients with skin-restricted LE. We aimed to compare the frequencies of MetS and its components in discoid LE (DLE) with the non-DLE control group. Additionally, we intended to determine the differences of sociodemographic and clinical data of the DLE patients with MetS compared to the patients without MetS. This was a cross-sectional, case-control study, including 60 patients with DLE and 82 age- and gender-matched control subjects. In DLE group, the presence of MetS was observed as more frequent (48.3% versus 24.4%, p=0.003), and hypertriglyceridemia (43.3% versus 22.0%, p=0.006) and reduced HDL-cholesterol (61.7% versus 23.2%, p<0.001) among the MetS components were found significantly higher when compared to the control group. DLE patients with MetS were at older age (50.45±11.49 versus 43.06±12.09, p=0.02), and hypertension, hyperlipidemia/dyslipidemia, and cardiovascular disease histories were observed at a higher ratio when compared to the patients without MetS. Between the DLE patients with and without MetS, no significant difference was observed in terms of clinical characteristics of DLE. Moreover, further large case-control studies with follow-up periods would be required to clearly assess the impact of MetS on the clinical outcomes of DLE.

scholarly journals Automated Evaluation ofCrithidia luciliaeBased Indirect Immunofluorescence Tests: A Novel Application of the EUROPattern-Suite Technology

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Stefan Gerlach ◽  
Kai Affeldt ◽  
Lena Pototzki ◽  
Christopher Krause ◽  
Jörn Voigt ◽  
...  
Keyword(s):  
Indirect Immunofluorescence ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Automated Evaluation ◽  
Crithidia Luciliae ◽  
Moderate Sensitivity ◽  
Major Criterion ◽  
Increasing Demand ◽  
Dsdna Antibodies

Systemic lupus erythematosus (SLE) is a severe rheumatic autoimmune disease with various clinical manifestations. Anti-dsDNA antibodies are an important immunological hallmark of SLE and their occurrence represents a major criterion for the diagnosis. Among the commonly applied test systems for determination of anti-dsDNA antibodies, the indirect immunofluorescence test (IIFT) using the flagellatedkinetoplastida Crithidia luciliaeis considered to be highly disease specific at moderate sensitivity. Since IIFT, however, is claimed to be affected by subjective interpretation and a lack of standardization, there has been an increasing demand for automated pattern interpretation of immunofluorescence reactions in recent years. Corresponding platforms are already available for evaluation of anti-nuclear antibody (ANA) IIFT on HEp-2 cells, the recommended “gold standard” for ANA screening in the diagnosis of various systemic rheumatic autoimmune diseases. For one of these systems, the “EUROPattern-Suite” computer-aided immunofluorescence microscopy (CAIFM), automated interpretation of microscopic fluorescence patterns was extended to theCrithidia luciliaebased anti-dsDNA IIFT.

scholarly journals Clinical significance of anti-C1q antibodies in SLE

2015 ◽  
Vol 62 (s11) ◽  
pp. 15-20
Author(s):  
Ivana Stiborová ◽  
Vlastimil Král ◽  
Jozef Rovenský ◽  
Stanislava Blažíčková
Keyword(s):  
Lupus Erythematosus ◽  
Disease Index ◽  
High Avidity ◽  
Group Score ◽  
Renal Functions ◽  
Persistent Proteinuria ◽  
Double Stranded Dna ◽  
Significant Difference ◽  
History Of ◽  
Dsdna Antibodies

Abstract Lupus nephritis (LN) is a severe and frequent complication of systemic lupus erythematosus (SLE). Untreated cases very often lead to patients’ death; therefore, it is important to use markers sensitive and specific enough for the diagnosis and subsequent monitoring of nephritis. Autoantibodies against double-stranded DNA (anti-dsDNA) are believed to play a major role in SLE in general and so their significance in prediction and monitoring of glomerular inflammation is low. For prediction of renal flares and effective, well-timed therapy, it is required to have an appropriate marker available. In our study, we have tested sera of 85 SLE patients with or without LN. The criterion for LN determination was the degree of proteinuria (persistent proteinuria > 0.5 g/day, according to ACR criteria for LN). Disease activity was described by SLE disease index (SLEDAI) score, renal functions were stated according to British Isles Lupus Assessment Group score. There were anti-C1q, total anti-dsDNA and high-avidity anti-dsDNA detected in the patients’ sera. We did not find any significant difference in average SLEDAI value between patients with renal and non-renal organ complications. Positivity of anti-C1q was more frequent in patients with nephritis than in those without any history of renal disease (58.3 vs. 39.1%). Higher prevalence of these antibodies was evident in patients with clinically active LN than in those without renal improvement (73.1 vs. 39.1%). When comparing anti-C1q with antibodies against structures of DNA, significant differences were found in case of high avidity anti-dsDNA. Our results have confirmed the studies showing that anti-C1q antibodies could serve as a reliable serological marker of LN activity along with other laboratory tests. Detection of anti-C1q together with high avidity anti-dsDNA antibodies seems to be a good algorithm for the prediction of possible renal flares in SLE patients.

The clinical significance of borderline results of the Elia CTD Screen assay

2018 ◽  
Vol 56 (12) ◽  
pp. 2088-2092
Author(s):  
Christoph Robier ◽  
Omid Amouzadeh-Ghadikolai
Keyword(s):  
Clinical Significance ◽  
Lupus Erythematosus ◽  
Medical Records ◽  
Antinuclear Antibodies ◽  
Solid Phase ◽  
Sequential Screening ◽  
Nuclear Antigens ◽  
Low Concentrations ◽  
Thermo Fisher Scientific ◽  
Fisher Scientific

Abstract Background Data on the clinical relevance of borderline results of solid-phase assays in the screening for antinuclear antibodies (ANA) are sparse. This study aimed to determine the clinical significance of borderline results of the Elia CTD Screen (ECS; Phadia/Thermo Fisher Scientific, Freiburg, Germany), a fluoroenzymeimmunoassay incorporating 17 recombinant human nuclear antigens. Methods We retrospectively examined the medical records of 143 subjects with borderline ECS results for ANA-associated autoimmune disorders (AASARD) and the association with the results of indirect immunofluorescence (IIF) and confirmatory assays for ANA. Results AASARD were diagnosed in 10 patients (7%) with systemic lupus erythematosus (n=5; four patients were prediagnosed and in clinical remission), polymyositis overlap syndromes (n=2), scleroderma, Raynaud’s syndrome and undetermined connective tissue disease (each n=1). Most frequently, homogeneous and nucleolar IIF patterns were found. Positive ANA subsets were observed in three patients. Furthermore, four patients were diagnosed with autoimmune liver diseases and yielded positive IIF in three and positive confirmatory assays in all cases. Taken together, 129 subjects had no AASARD. Within this group, 43 patients were IIF positive and most frequently showed speckled, unspecific nucleolar and only rarely homogeneous patterns. Positive ANA subsets were found in low concentrations near to the upper reference range in 18 subjects. Conclusions AASARD were observed in 7% of the subjects with borderline ECS and showed homogeneous or nucleolar IIF patterns in the majority of these cases. Our findings suggest that borderline results of the ECS can be clinically relevant and support the concept of a parallel or sequential screening for ANA by both ECS and IIF.

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