THE CLINICAL-SIGNIFICANCE OF ANTINUCLEAR ANTIBODIES IN CONNECTIVE-TISSUE DISEASE

Antinuclear antibodies (ANA) are often present in connective tissue di seases. In 279 non-selected patients with connective tissue disease, i nflammatory and degenerative joint disease, in some patients with chro nic infectious diseases and malignancies and in the presence of some u nclear pathologic conditions in patients whose serum reacted positivel y to ANA, we analyzed the type of immunofluorescence and the presence of extractable antinuclear antibodies (ENA). In systemic lupus erythem atosus, the prevailing immunofluorescence is type H (homogenous) (60.6 %), anti-Ro/SS-A appears in 24.2%. anti-Sm and anti-RNP in 12.1%. In S jogren's syndrome, type S prevails (47.6%), anti-Ro/SS-A and anti-La/S S-B are present in 52.4%, only anti-Ro/SS-A in 28.6%. In systemic scle rosis, the prevailing immunofluorescence is type S (37.5%), in 75% a p ositive anti-Scl-70 antibody is present. In mixed connective tissue di sease, anti-RNP appears in 85.7%. In dermatopolymyositis, the ant-Jo-1 antibody is present in 33.3%. In undifferentiated connective tissue d isease, type S immunofluorescence appears in 70%. In rheumatoid arthri tis the prevailing immunofluorescence is type H (homogenous) (46.4%) a nd type S (speckled) (41.0%), while the presence of ENA is rare (anti- Ro/SS-A in 4.6%). In spondylarthritis, type S immunofluorescence appea rs most often (62.5%). Patients with chronic infectious disease, malig nancies, undefined conditions and degenerative joint disease present w ith Various types of immunofluorescence; the presence of ENA is extrem ely rare in these patients. The results of this study underline the si gnificance of ANA and, particularly ENA: in the diagnosis of connectiv e tissue disease. These antibodies however, can also be identified in various infectious and malignant diseases as well as in inflammatory a nd degenerative joint diseases.