ORIGINAL ARTICLES
The clinical significance of antinucleolar antibodies
1 Path Links Immunology, Scunthorpe General Hospital, Scunthorpe, UK
2 Department of Rheumatology, Diana Princess of Wales Hospital, Grimsby, UK
3 Department of Immunology, Hull Royal Infirmary, Hull, UK
4 Department of Biomedical Sciences, University of Lincoln, Lincoln, UK
Correspondence to:
Dr S Khan, Path Links Immunology, Scunthorpe General Hospital, Scunthorpe DN15 7BH, UK; sujoykhan{at}gmail.com
Background: The importance of antinucleolar antibodies seen by indirect immunofluorescence on HEp-2 cells, although associated with systemic sclerosis (SSc), in unselected patients is unknown.
Aims: To determine the true clinical significance of antinucleolar antibodies in an unselected patient population.
Methods: Antinucleolar antibody (ANoA) positive samples were identified in the immunology laboratory during routine autoimmune screening tests; case notes were reviewed using a standard proforma.
Results: 104 patients with ANoA were identified and ANoA+ samples were subclassified into homogeneous, clumpy and speckled antinucleolar types. SSc was evident in only two (1.8%) patients. Other connective tissue diseases were identified in 33 patients (32%); 22 patients (21%) had evidence of various malignancies. Both disordered liver function and anaemia were seen in 22 patients and were the commonest laboratory abnormalities.
Conclusions: Neither the presence nor subtype of ANoA is specific for systemic sclerosis. Laboratory comments appended to results should reflect this fact.
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