Pattern of Indirect Immunofluorescence Assay Antinuclear Antibody in Pediatric Lupus Nephritis

Fadhila Novianti, Reni Ghrahani, Noormarina Indraswari

Abstract


Objective: To determine the association between Anti-Nuclear Antibody (ANA) pattern in pediatric Systemic Lupus Erythematosus (SLE) patients and proteinuria as a sign of renal involvement in SLE.

Methods: This was a cross-sectional study, using data from medical records involving 89 newly diagnosed with SLE (aged ≤ 18 years) in Department of Child Health Dr. Hasan Sadikin General Hospital, Bandung, from January 1st 2018 to June 30th 2019. Data of ANA pattern and proteinuria were collected from medical record. ANA pattern was examined by Immunofluorescence Assay (IFA) method. Chi-square was used to analyze the association between ANA pattern and proteinuria as a sign of renal involvement in pediatric SLE patients.

Results: There were 89 patients, consisting of 7 male (7.9%) and 82 female (92.%) with median age of 14 (IQR=12-16).  There were only 44 pattern of ANA as follow: homogenous 56.8%, speckled 36.4%, and nucleolar 6.8%. However, there is no significant association between homogenous pattern with proteinuria events (p=0.831).

Conclusions: Homogenous pattern was the most frequent ANA pattern in children with SLE, and the pattern has no association with proteinuria events.


Keywords


Antinuclear Antibody Pattern; Indirect Immunofluorescence Assay; Proteinuria; Systemic Lupus Erythematosus

Full Text:

PDF

References


Vinay K, Abul KA, Jon CA. Robbins and cotran pathologic basis of disease. 9th edition. Philadelphia: Elsevier Saunders. 2014. p. 211–226.

Lehman TJA, Taber SF, Nuruzzaman F. Systemic lupus erythematosus in childhood and adolescence. in: dubois’ lupus erythematosus and related syndromes. 9th ed. Elsevier Inc. 2018. p. 520–531.

Samanta M, Nandi M, Mondal R, Hazra A, Sarkar S, Sabui T, et al. Childhood lupus nephritis: 12 years of experience from a developing country’s perspective. Eur J Rheumatol. 2017;4(3):178–183.

Kasjmir YI, Handono K, Wijaya LK, Hamijoyo L, Albar Z, Kalim H, et al. Rekomendasi Perhimpunan Reumatologi Indonesia untuk diagnosis dan pengelolaan lupus eritematosus sistemik. 2011. p. 1–54.

Almaani S, Meara A, Rovin BH. Update on lupus nephritis - nephrology rounds. Clin J Am Soc Nephrol. 2017;12:825–35.

Szymanik-Grzelak H, Kuźma-Mroczkowska E, Małdyk J, Pańczyk-Tomaszewska M. Lupus nephritis in children-10 years’ experience. Cent Eur J Immunol. 2016;41(3):248–54.

Lam N-CV, Ghetu M V, Bieniek ML. Systemic lupus erythematosus: Primary care approach to diagnosis and management. Am Fam Physician. 2016;94(4):284–94.

Sinha R, Raut S. Pediatric lupus nephritis: Management update. World J Nephrol. 2017;3(2):16.

Zhu J, Wu F, Huang X. Age-related differences in the clinical characteristics of systemic lupus erythematosus in children. Rheumatol Int. 2013;33(1):111–15.

Ghrahani R, Setiabudiawan B, Sapartini G. Karakteristik Pola Antibodi Antinuklear pada Anak dengan Systemic Lupus Erythematosus serta Komplikasinya. J Indon Med Assoc. 2012;62(7:)273–76.

Gomez RLA, Uribe U, Uribe O, Romero HG, Cardiel MH, Wojdyla D, et al. Childhood systemic lupus erythematosus in Latin America: The GLADEL Experience in 230 children. Lupus. 2008;17(6):592–604.

Mengeloglu Z, Tas T, Kocoglu E, Aktas G, Karabork S. Determination of anti-nuclear antibody pattern distribution and clinical relationship. Pak J Med Sci. 2014;30(2):380–3.

Yilmaz O, Karaman M, Ergon MC, Bahar IH, Yulug N. Comparison of indirect immunoflourescence and enxyme immunoassay methods for the determination of antinuclear antibodies. Mikrobiyol Bul. 2014;38(1-2):85–90.

Damoiseaux J, Andrade LEC, Carballo OG, Conrad K, Francescantonio PLC, Fritzler MJ, et al. Clinical relevance of HEp-2 Indirect immunoflourescent patterns: the International Concensus on ANA Patterns (ICAP) perspective. Ann Rheum Dis. 2019;78:879–89.

Damoiseaux J, Andrade LEC, Carballo OG, Conrad K, Francescantonio PLC, Fritzler MJ, et al. International consensus on ANA patterns (ICAP): the bumpy road towards a consensus on reporting ANA results. 2016;7(1);1–8.

Cruvinel WdM, Andrade LEC, von Mühlen CA, Dellavance A, Ximenes AC, Bichara CD, et al. V Brazilian consensus guidelines for detection of anti-cell autoantibodies on hep-2 cells. Adv Rheumatol. 2019;59(1):28.

Chan EKL, Damoiseaux J, Cruvinel WdM, Carballo OG, Conrad K, Francescantonio PLC, et al. Report on the second International Consensus on ANA Patterns (ICAP) workshop in Dresden 2015. Lupus. 2016;25:797–804.

Frodlund M, Dahlstrom O, Kastbom A, Skogh T, Sjowall C. Associations between antinuclear antibody staining patterns and clinical features of systemic lupus erythematosus: analysis of a regional Swedish register. BMJ Open. 2013;3(6):1–8.

Ricchiuti V, Adams J, Hardy DJ, Katayev A, Fleming JK. Automated Processing and Evaluation of Anti-Nuclear Antibody Indirect Immunofluorescence Testing. Front Immunol. 2018;9:927.




DOI: https://doi.org/10.15850/ijihs.v8n1.1911

Article Metrics

Abstract view : 610 times
PDF - 290 times



 

This Journal indexed by

                       

         


Creative Commons License
IJIHS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License



View My Stats