Analysis of Antinuclear Antibodies in Rheumatoid Arthritis: Limited Correlation with Disease Activity and Systemic Involvement

초록

This study was aimed to evaluate the prevalence, titer and patterns of antinuclear antibody (ANA) expression, and its clinical significance in patients with rheumatoid arthritis (RA). Methods : We divided 259 patients with seropositive RA into ANA positive and negative groups and compared with clinical variables. Results : ANA was expressed in 47.5% of the patients with seropositive RA. Most of the patterns of ANA were either homogenous (52.8%) or speckled (36.6%). Most frequently expressed anti-extractable nuclear antigen (ENA) antibody was the anti-Ro antibody (34.1%). Patients in the ANA positive group had higher frequency of anemia, lower hemoglobin concentration, more hot joint area on radionuclide whole body bone scan, and lower T-score on bone mineral density (BMD) than patients in the ANA negative group. But other clinical indices that reflect disease activity and systemic involvement were not significantly different between the two groups. Among the ANA positive patients, those with high ANA titer were older and had lower hemoglobin concentration than the patients with low ANA titer. Conclusion : Almost the half of seropositive RA patients expressed ANA and most of them showed homogenous and speckled pattern. Anti-Ro antibody was the most frequent anti-ENA antibody. With the exception of anemia, hot joint area in whole body bone scan, and lumbar spine BMD, the expression of ANA in patients with RA did not reflect disease activity or systemic involvement accurately