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anti ds-DNA test & SLE

What is Anti ds-DNA test This test measures the amount of antibody to doublestranded deoxyribonucleic acid (anti-dsDNA) that may be present in the blood. Anti-dsDNA is an autoantibody, produced when a person's immune system fails to distinguish between "self" and "nonself" cellular components. It mistakenly targets and attacks the body's own genetic material, causing inflammation, tissue damage, and other signs and symptoms that are associated with an autoimmune disorder. Anti-dsDNA is one of several antinuclear antibodies (ANA), a group of antibodies directed against substances found in the nucleus of cells. While it may be present at a low level with a number of disorders, anti-dsDNA is primarily associated with the autoimmune disorder systemic lupus erythematosus (SLE or Lupus). What is SLE Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that has protean manifestations and follows a relapsing and remitting course. It is characterized by an autoantibody response to nuclear and cytoplasmic antigens. SLE can affect any organ system, but mainly involves the skin, joints, kidneys, blood cells, and nervous system The diagnosis of SLE must be based on the proper constellation of clinical findings and laboratory evidence. SLE can affect the kidneys, joints, blood vessels, skin, heart, lungs, and the brain. What are the symptoms Symptoms may include joint pain, rashes, fatigue, and kidney dysfunction. SLE occurs most frequently in women between the ages of 15 to 40 and is more common in non-Caucasians. While no direct cause is known, there may be some genetic predisposition. Certain drugs, chemicals, sunlight, or viral infections may trigger an episode. One particularly serious complication of SLE is lupus nephritis, a condition characterized by inflammation of the kidneys, which can lead to protein in the urine, high blood pressure, and kidney failure. It occurs when the autoantibodies bind to antigens and become deposited in the kidneys. Laboratory Studies Screening laboratory studies to diagnose possible SLE should include the following:

Complete blood count (CBC) with differential Serum creatinine Urinalysis with microscopy The CBC count may help to screen for leukopenia, lymphopenia, anemia, and thrombocytopenia. Urinalysis and creatinine studies may be useful to screen for kidney disease.

Autoantibody tests in the diagnosis of SLE:

ANA - Screening test; sensitivity 95%; not diagnostic

without clinical features Anti-dsDNA - High specificity; sensitivity only 70%; level variable based on disease activity Anti-Sm - Most specific antibody for SLE; only 30-40% sensitivity Anti-SSA (Ro) or Anti-SSB (La) - Present in 15% of patients with SLE and other connective-tissue diseases such as Sjgren syndrome; associated with neonatal lupus Anti-ribosomal P - Uncommon antibodies that may correlate with risk for CNS disease, including increased hazzards of psychosis in a large inception cohort, although the exact role in clinical diagnosis is debated Anti-RNP - Included with anti-Sm, SSA, and SSB in the ENA profile; may indicate mixed connective-tissue disease with overlap SLE, scleroderma, and myositis

Anticardiolipin - IgG/IgM variants measured with

enzyme-linked immunoassay (ELISA) are among the antiphospholipid antibodies used to screen for antiphospholipid antibody syndrome and pertinent in SLE diagnosis Lupus anticoagulant - Multiple tests (eg, direct Russell viper venom test) to screen for inhibitors in the clotting cascade in antiphospholipid antibody syndrome Direct Coombs test - Coombs testpositive anemia to denote antibodies on RBCs Anti-histone - Drug-induced lupus ANA antibodies are often of this type (eg, with procainamide or hydralazine; perinuclear antineutrophil cytoplasmic antibody [pANCA]positive in minocycline-induced drug-induced lupus)

Abstracts fromMedscape reference of Drugs, Disease & Procedures - http://emedicine.medscape.com /article/332244

Lupus Erythematosus Diagnosis

diagnostic solutions for Lupus Erythematosus

A subsidiary of Omega Diagnostics Group PLC

ELISA Kit with Break Apart Wells

Microwells coated with human ds-DNA Calibrator range 0-400 U/ml for IgG Color coded ready to use reagents

70 minutes incubation time Incubations at Room Temperature

2.5 IU/ml sensitivity

Latex agglutination test Detects serum antinucleoprotein factors

Qualitative test Positive & negative controls included

1 minute protocol