OBJECTIVETo explore the follow-up visit, outcome and auxiliary diagnosis method on the cases with indeterminate antibody level measured by Western blotting as well as the related biological factors.

METHODSThe cases with indeterminate result were followed up according to the National Guideline for Detection of HIV/AIDS (2009) and samples were collected for HIV antibody detection, p24 antigen and nucleic acid were detected as a supplementary diagnosis at the same time. The samples were also be detected for HBV, HCV, TP, HTLV-I/II, ANA, and AFP, and the results were compared to that of screened positive and confirmed negative cases.

RESULTSA total of 73 were followed up successfully and taken a second HIV test, 25 cases were tested positive and 48 were tested negative for HIV during the follow-up period. For the 25 HIV positive cases, the HIV seroconversion rate was 100.00% at any time point when the interval between the first and returning detection was longer than 1 week. The major Western blotting bands for the cases with indeterminate result were p24 and gp160 and it was different between HIV positive and negative cases in Western blotting band profiles. The consistency and sensitivity of nucleic acid detection were higher than 90.00%, and were higher than that of p24 antigen (69.09% (38/55) and 27.27% (6/22)) (χ(2)(consistency) = 6.875, χ(2)(sensitivity) = 18.893, P < 0.05). The positive rates of ANA and AFP of indeterminate cases excluded from HIV infection were 20.83% (10/28) and 6.25% (3/48) and higher than that of screened positive and confirmed negative cases (0.00%), the difference had statistic significance (χ(2)(ANA) = 19.430, χ(2)(AFP) = 5.520, P < 0.05).

CONCLUSIONIt is critical to get timely diagnosis for the indeterminate cases according to the new national guideline for detection of HIV/AIDS. Nucleic acid detection has higher application value as auxiliary diagnosis for HIV infection than p24 antigen. The increased levels of ANA and AFP may be the factors resulting in the nonspecific indeterminate results.

Antibodies, Antinuclear ; blood ; Female ; Follow-Up Studies ; HIV Antibodies ; blood ; HIV Infections ; diagnosis ; immunology ; Humans ; Male ; alpha-Fetoproteins ; analysis

Antibodies, Antinuclear ; blood ; Autoantibodies ; blood ; Autoimmunity ; Biomarkers ; blood ; Hepatitis C ; blood ; immunology ; Humans ; Mitochondria ; immunology ; Muscle, Smooth ; immunology ; Retrospective Studies

Adolescent ; Antibodies, Antinuclear ; blood ; Child ; Female ; Humans ; Sjogren's Syndrome ; diagnosis ; immunology ; therapy

We report a case of Winkelmann granuloma in a 63-year-old man. nstopathological findings of the biopsy specimens from the lesions of the ear, finger and iliac crest area were compatible with Winkelmann granuloma. Winkelmann granuloma is a rare disorder showing an association with systemic immunoreactive disorders. Although our patient did not have any definite systemic disease, he had characteristic clinical and histopathological findings of Winkelmann granuloma, arthralgia, an elevated erythrocyte sedimentation rate, positivity to the rheumatoid factor and antinuclear antibodies. Therefore, we believed that he was strongly suspected to have an unclassifiable systemic immunoreactive disease.
Antibodies, Antinuclear ; Arthralgia ; Biopsy ; Blood Sedimentation ; Ear ; Fingers ; Granuloma* ; Humans ; Middle Aged ; Rheumatoid Factor

BACKGROUND: Identification of specific antinuclear antibodies is useful for the diagnosis, subclassification and determination of prognosis in autoimmune disorders. In many diseases, multiple autoantibodies are detected, and simultaneous detection of multiple autoantibodies has been shown to be useful. Recently, a commercial kit (EL-ANA/6 profiles, TheraTest Laboratories, USA) losing enzyme-linked immunosorbent assay (ELISA) method for detection of six specific autoantibodies is avallable. In this study, we attempted to compare the results of EL-ANA/6 profiles with those of routinely used methods and evaluated usefulness of EL-ANA/6 profiles. METHODS: EL-ANA/6 profiles were performed with 28 sera which were positive for fluorescent antinuclear antibody (FANA) Simultaneously we tested anti-dsDNA antibodies with immnofluorescent (If) method and anti-Sm, anti-RNP, anti-SSA and anti-SSB antibodies with double immunodiffusion (DID). To evaluate specificity, EL- ANA/6 profiles tests were performed on 10 sera from healthy blood donors. RESULTS: Ten sera of healthly blood donors were all negative for EL-ANA/6 pro biles. In the results of EL-ANA/6 profiles on sera positive for FANA, the concordance rate with IF method for the anti-dsDNA antibodies was 89.3% (25/28) and the con- cordance rates with DID for anti-Sm, anti-Sm/RNP, anti-SSA and anti-SSB antibodies were 85.7% (24/28), 82.1% (23/28), 92.9% (26/28) and 82.1% (23/28), respectively. In 16 discordant settings, thirteen (81.3%) were negative on DID and positive on EL-ANA/6 profiles. CONCLUSIONS: The results of the EL-ANA/6 profiles show good concordance rates with If and DID. EL-ANA/6 profiles showing quantitative profiles for multiple autoantibodies is useful for diagnosis and tool)ow-up of autoimmune disorders.
Antibodies ; Antibodies, Antinuclear* ; Autoantibodies ; Bile ; Blood Donors ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunodiffusion ; Prognosis ; Sensitivity and Specificity

Adolescent ; Antibodies, Antinuclear ; blood ; Child ; Histiocytic Necrotizing Lymphadenitis ; etiology ; Humans ; Lupus Erythematosus, Systemic ; complications ; Male ; Sjogren's Syndrome ; complications

BACKGROUNDSkin lesions are common manifestations in systemic lupus erythematosus (SLE). It is still unknown what the definite pathogenesis of skin involvement was and whether DNA participated in it. Our study was designed to explore the pathogenetic role and nature of nuclear antigen (DNA) deposited in the skin lesions of patients with SLE.

METHODSThirty skin samples from patients with SLE and 2 normal skin samples were studied. Extracellular DNA was evaluated by indirect immunofluorescence methods. The deposited immune complexes were extracted by cryoprecipitation, and DNA was then isolated with phenol and chloroform. DNA fragment sizes were detected by agarose gel electrophoresis. Finally, 8 different probes were used to analyze the origin of these DNA molecules using Dot hybridization.

RESULTSExtracellular DNA staining was found only in skin lesions, mainly those located in the basement membrane zone, vascular wall, and hair follicle wall. Normal skin and non-lesion SLE skin showed no fluorescence at locations outside the nuclei. There were no differences in the rate and intensity of extracellular DNA staining when comparing active phase to remission phase patients. No relationship was found between extracellular DNA and circulating anti-dsDNA antibodies. Deposited DNA fragments clustered into four bands of somewhat discrete sizes: 20 000 bp, 1300 bp, 800-900 bp, 100-200 bp. Small sized fragments (100-200 bp) were positively correlated with disease activity (P < 0.05, r = 0.407). Dot hybridization showed significant homology of the various extracellular DNA fragments examined with human genomic DNA, but not with DNA from the microorganisms and viruses we examined. There were also homologies between DNA samples from different individuals.

CONCLUSIONSDNA and its immune complexes may contribute to the pathogenesis of skin lesions in SLE. These DNA molecules range in size from 100 bp to 20 kb and may be endogenous in origin.

Antibodies, Antinuclear ; blood ; Antigen-Antibody Complex ; analysis ; DNA ; analysis ; immunology ; Humans ; Lupus Erythematosus, Systemic ; immunology ; Skin ; immunology ; Staining and Labeling

BACKGROUND/AIMS: Exclusion of liver disease from other causes such as autoimmune hepatitis is necessary for diagnosis of nonalcoholic fatty liver disease (NAFLD). However, there has been no study on the prevalence and significance of autoantibodies in the patients with clinically suspected NAFLD in Korea, where hepatitis B is endemic and autoimmune hepatitis is relatively uncommon. METHODS: We prospectively tested for anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA), and anti-mitochondrial antibody (AMA) in 135 serially enrolled patients with suspected NAFLD. We compared the clinical characteristics and biochemical indices of the ANA-positive or ASMA-positive group with those of the autoantibody-negative group. RESULTS: Sixteen patients (11.8%) had serum autoantibodies; there was ANA in 8 patients (5.9%), ASMA in 7 (5.1%), and AMA in 2 (1.5%). Both ANA and AMA were positive in one patient. The ANA-positive or ASMA-positive group showed an older age (49.5+/-13.0 vs. 42.0+/-10.9 years, respectively, P=0.018) and higher levels of serum globulin (3.1+/-0.4 vs. 2.9+/-0.4 g/dL, respectively, P=0.037), compared with the autoantibody-negative group. Two cases with positive ANA or ASMA fulfilled the diagnostic criteria for probable autoimmune hepatitis and two cases with positive AMA were suspected as primary biliary cirrhosis. CONCLUSIONS: These findings suggest that autoantibodies could be found in some patients with suspected NAFLD in Korea, AMA-positivity or ASMA-positivity could be associated with old age and high serum globulin, and some of the autoantibody-positive cases could be diagnosed as autoimmune hepatitis or primary biliary cirrhosis. Further studies are necessary to clarify the clinical significance of autoantibody positivity in those patients.
Adult ; Aged ; Antibodies, Antinuclear/analysis ; Autoantibodies/*blood ; English Abstract ; Fatty Liver/*immunology ; Female ; Humans ; Male ; Middle Aged ; Muscle, Smooth/immunology

Cutanenous lupus mucinosis is a rare variant of lupus erythematosus eruptions. A 36-year-old female presented with a 1-year history of 1-2cm sized, skin colored, multiple nodules on the back. She had previously been diagnosed as having systemic lupus erythematosus 10 years ago. A complete blood count showed lymphopenia. Antinuclear antibodies (ANA) were positive at a titer of 1: 640. Anti-Sm and ds-DNA were also positive. Histopathological findings showed that the collagen fibers in the upper dermis were loosely arranged and separated by amorphous materials. These materials were all positive for alcian blue staining. This case is compatible with cutaneous lupus mucinosis.
Adult ; Alcian Blue ; Antibodies, Antinuclear ; Blood Cell Count ; Collagen ; Dermis ; DNA ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Mucinoses* ; Skin

OBJECTIVE: To investigate the clinical characteristics of relapsing polychondritis (RP) in Korea. METHODS: We retrospectively reviewed 16 patients with RP who were diagnosed at Seoul National University Hospital and Gyeongsang National University Hospital in the period from July 1987 to August 2003. RESULTS: There were 9 males and 7 females, the mean age was 45.4+/-12.8 years. The frequency of clinical manifestation was as follows; auricular chondritis (81.3%), nasal chondritis (68.8%), ocular inflammation (56.3%), respiratory tract involvement (56.3%), arthritis (50%) and audio-vestibular damage (25%). Westergren erythrocyte sedimentation rate (ESR) was elevated in 53.3% and antinuclear antibody (ANA) was positive in 20% of study patients. Rheumatoid factor was negative in all cases. CONCLUSION: Clinical manifestations were comparable to the reports of Western countries. However, the frequency of arthritis was lower in Korean patients with RP than Western reports.
Antibodies, Antinuclear ; Arthritis ; Blood Sedimentation ; Female ; Humans ; Inflammation ; Korea* ; Male ; Polychondritis, Relapsing* ; Respiratory System ; Retrospective Studies ; Rheumatoid Factor ; Seoul