Whether the inflammatory arthritis in two of them (Case 10 and 15, Table 2) along with severe drug reaction and the positive antinuclear antibody
status in all three has placed them at risk for multiple drug allergy remains to be seen.
Clinical features and evolution of antinuclear antibody
positive individuals in a rheumatology outpatient clinic.
Recommended labs include a complete blood count and an additional work-up for anemia, complete metabolic panel, urinalysis, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody
, complement C3 and C4, and antiphospholipid and anticardiolipin antibodies.
2 Herein we report a patient whose male gender, young age, unusual presentation and negative antinuclear antibody
(ANA) test created some diagnostic difficulties.
, anti-nRNP antibody and anti-histone antibody were positive; however, anti-dsDNA antibody, anti-sm antibody, anticardiolipin antibody, rheumatoid factor, Coombs test (direct and indirect) and CD55CD59 were negative.
The antibodies are directed against salivary duct antigen, increase in [beta]-2 microglobulin in saliva and synovial fluid, general immune abnormalities including hypergammaglobulinemia, rheumatoid factor, antinuclear antibody
, anti-DNA (Deoxyribonucleic acid) antibody and increased Erythrocyte Sedimentation Rate levels have been observed (4).
As such, the serology is normal: There is no elevation in erythrocyte sedimentation rate or C-reactive protein, and antinuclear antibody
and rheumatoid factor testing will be negative.
Additionally, many patients with morphea have antinuclear antibody
and rheumatoid factor autoantibodies.
Etiologic tests were as follows: HBs Ag: (-), antiHBs: (-), antiHCV: (-), antiHlV: (-), antinuclear antibody
The results of antinuclear antibody
testing were negative (indirect immunofluorescence, screening dilution 1:40).
In addition to the local cutaneous immunologic changes, UVA can also induce antinuclear antibody
formation in both animal and human models.
Guidelines for clinical use of the antinuclear antibody
test and tests for specific autoantibodies to nuclear antigens.