POSITIVITY FOR ANTINUCLEAR ANTIBODY IN PATIENTS WITH ADVANCED RHEUMATOID-ARTHRITIS

Some patients with rheumatoid arthritis (RA) as well as those with oth er collagen diseases are positive for antinuclear antibody (ANA). We i nvestigated the frequency of positivity for ANA in 104 patients with R A and evaluated the clinical features and laboratory data in the ANA-p ositive and -negative groups. The presence of ANA in sera was studied by indirect immunofluorescence using HEp-2 cells as the antigen substr ate. Sera with a positive fluorescence at a dilution of 1:20 were cons idered to be positive for ANA. Of the 104 patients, 39 (37.5%) were po sitive for ANA. The staining pattern in the positive cases varied, but most were speckled (64.1%) and homogeneous (48.7%). A small number sh owed a nucleolar (20.5%) or a centromere (10.3%) pattern. None showed a shaggy pattern. The ANA titer was lower in RA patients compared with those with other collagen-related diseases such as systemic lupus ery thematosus or progressive systemic sclerosis. None of the patients pos itive for ANA with either a nucleolar or centromere staining pattern h ad progressive systemic sclerosis or the CREST syndrome. One patient e ach had Raynaud's phenomenon and pulmonary fibrosis. There was no corr elation between ANA positivity and indicators of joint inflammation. T he prevalence of ANA positivity in patients with advanced or prolonged disease was higher than those with early stages or short durations. T here was no correlation with drug therapy.