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Clinical Relevance of Antinuclear Antibodies (ANA) in Patients with Hypersensitivity Pneumonitis (HP): A Single Centre Experience
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A3019 - Clinical Relevance of Antinuclear Antibodies (ANA) in Patients with Hypersensitivity Pneumonitis (HP): A Single Centre Experience
Author Block: F. Bonella1, J. Sennekamp2, M. Joest2, M. Rolke3, S. Ohshimo4, J. Guzman5, C. Taube1, U. Costabel1; 1Ruhrlandklinik University Hospital, University Duisburg-Essen, Essen, Germany, 2Malteser Lung and Allergy Center,, Bonn, Germany, 3Pneumology Praxis, Aschaffenburg, Germany, 4Emergency and Critical Care Medicine, Hiroshima University, Hiroshima, Japan, 5General and Experimental Pathology, Ruhr-University, Bochum, Germany.
Background: ANA have been reported in 30-40% of patients with idiopathic interstitial pneumonia, and in about 15 % of patients with HP. The clinical relevance of these antibodies in HP has been poorly investigated.
Aim: To investigate the presence of ANA antibodies and their correlation with clinical variables and disease outcome in HP.
Patients and methods: 64 patients with HP (40 F, 24 M), followed in our centre between 2007 and 2013 were retrospectively studied. ANA screening was performed using indirect immunofluorescence (IF) on HEp-2 cell line. ANA titers were considered as elevated when higher than 1:160. For ANA differentiation, a semiquantitative Immunoblot assay (EUROLINE ANA Profil 23; Euroimmun, Germany) was used. Disease progression was defined as decline in FVC >10% pred. and/or DLCO ≥ 15% pred. and/or worsening of radiological infiltrates.
Results: Of 64 patients, 56 had chronic and 8 acute/subacute HP. During follow up (mean 38±2 months, range 1-60), 24 patients (37.5%) had disease progression. 25 patients (39%) were ANA positive. ANA were more frequently detected in females than in males (47 vs 33%, p=0.06) and in elderly patients (p=0.07). The most frequent ANA subtypes were Ro-52 (20%) and SSB (12%). No difference was found in lung function, blood gas values and serum LDH between ANA positive and ANA negative patients. ANA positive patients had a higher BAL neutrophil count than those who were ANA negative (14±4 vs 6±1%, p=0.015). ANA positivity did not correlate with disease duration, disease progression, or survival.
Conclusion: The ANA positivity rate in our HP cohort is higher than previously reported, but no correlation with clinical variables or disease outcome was found.
Author Block: F. Bonella1, J. Sennekamp2, M. Joest2, M. Rolke3, S. Ohshimo4, J. Guzman5, C. Taube1, U. Costabel1; 1Ruhrlandklinik University Hospital, University Duisburg-Essen, Essen, Germany, 2Malteser Lung and Allergy Center,, Bonn, Germany, 3Pneumology Praxis, Aschaffenburg, Germany, 4Emergency and Critical Care Medicine, Hiroshima University, Hiroshima, Japan, 5General and Experimental Pathology, Ruhr-University, Bochum, Germany.
Background: ANA have been reported in 30-40% of patients with idiopathic interstitial pneumonia, and in about 15 % of patients with HP. The clinical relevance of these antibodies in HP has been poorly investigated.
Aim: To investigate the presence of ANA antibodies and their correlation with clinical variables and disease outcome in HP.
Patients and methods: 64 patients with HP (40 F, 24 M), followed in our centre between 2007 and 2013 were retrospectively studied. ANA screening was performed using indirect immunofluorescence (IF) on HEp-2 cell line. ANA titers were considered as elevated when higher than 1:160. For ANA differentiation, a semiquantitative Immunoblot assay (EUROLINE ANA Profil 23; Euroimmun, Germany) was used. Disease progression was defined as decline in FVC >10% pred. and/or DLCO ≥ 15% pred. and/or worsening of radiological infiltrates.
Results: Of 64 patients, 56 had chronic and 8 acute/subacute HP. During follow up (mean 38±2 months, range 1-60), 24 patients (37.5%) had disease progression. 25 patients (39%) were ANA positive. ANA were more frequently detected in females than in males (47 vs 33%, p=0.06) and in elderly patients (p=0.07). The most frequent ANA subtypes were Ro-52 (20%) and SSB (12%). No difference was found in lung function, blood gas values and serum LDH between ANA positive and ANA negative patients. ANA positive patients had a higher BAL neutrophil count than those who were ANA negative (14±4 vs 6±1%, p=0.015). ANA positivity did not correlate with disease duration, disease progression, or survival.
Conclusion: The ANA positivity rate in our HP cohort is higher than previously reported, but no correlation with clinical variables or disease outcome was found.
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