PMID- 12515370
OWN - NLM
STAT- MEDLINE
DCOM- 20030409
LR  - 20220331
IS  - 1121-8428 (Print)
IS  - 1121-8428 (Linking)
VI  - 15 Suppl 6
DP  - 2002 Nov-Dec
TI  - The use of laboratory tests in diagnosis and monitoring of systemic lupus 
      erythematosus.
PG  - S20-7
AB  - Clinical immunology laboratories play an essential role in diagnosis and 
      monitoring of systemic lupus erythematosus (SLE). To obtain the best results in 
      terms of diagnostic performance and clinical usefulness, the following 
      recommendations should be fulfilled: Indirect immunofluorescence on Hep-2 cells 
      remains the method of choice for the detection of anti-nuclear antibodies (ANA). 
      The sensitivity of ANA test for SLE is very high (almost 100%) but its 
      specificity low since ANA can be present in a number of different clinical 
      conditions and even in normal controls. Anti-dsDNA antibodies are highly specific 
      for SLE and present in a high proportion of SLE patients (40-80%). The method of 
      choice for anti-ds DNA is the Farr assay; however, the necessity of using 
      radioactive material decreases its applicability. As an alternative, 
      immunofluorescence on Crithidia Luciliae can be used in the diagnostic phase for 
      its high specificity. It is not advisable to use ELISA, in the diagnostic phase, 
      due to its low specificity. The quantitative determination of anti-dsDNA is 
      useful for monitoring patients, in particular in the presence of nephritis. For 
      monitoring, a quantitative method should be used (Farr assay or ELISA). The 
      detection of antibodies to extractable nuclear antigens (ENA) and to 
      phospholipids (Lupus anticoagulant and anti-cardiolipin antibodies with a beta2 
      glycoprotein I-dependent method) are useful to identify subgroups of patients at 
      risk for some clinical manifestations (i.e. anti-phospholipid syndrome). New 
      assays (anti-C1q and anti-nucleosome antibodies) have been recently proposed for 
      diagnosis (anti-nucleosome) and monitoring SLE patients (anti-C1q and 
      anti-nucleosome antibodies), with promising results. Among biological parameters, 
      urinary levels of monocyte chemoattranct protein 1 (MCP1) seem to be the most 
      useful to monitor nephritis activity in lupus patients.
FAU - Sinico, Renato Alberto
AU  - Sinico RA
AD  - Nephrology and Dialysis Unit and Center of Clinical Immunology and Rheumatology, 
      San Carlo Borromeo Hospital, Milan, Italy. renato.sinico@oscb.sined.net
FAU - Bollini, Bruna
AU  - Bollini B
FAU - Sabadini, Ettore
AU  - Sabadini E
FAU - Di Toma, Luca
AU  - Di Toma L
FAU - Radice, Antonella
AU  - Radice A
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Italy
TA  - J Nephrol
JT  - Journal of nephrology
JID - 9012268
SB  - IM
MH  - Clinical Laboratory Techniques/*standards
MH  - Humans
MH  - Lupus Erythematosus, Systemic/*diagnosis/*immunology/therapy
MH  - Monitoring, Immunologic/*standards
RF  - 45
EDAT- 2003/01/08 04:00
MHDA- 2003/04/10 05:00
CRDT- 2003/01/08 04:00
PHST- 2003/01/08 04:00 [pubmed]
PHST- 2003/04/10 05:00 [medline]
PHST- 2003/01/08 04:00 [entrez]
PST - ppublish
SO  - J Nephrol. 2002 Nov-Dec;15 Suppl 6:S20-7.