Antinuclear Antibodies May Predict Rheumatologic Conditions in Children

Children who present with high titers of antinuclear antibodies (ANA) may have an increased risk of developing an autoimmune rheumatological condition, according to findings from a retrospective study presented at the Paediatric and Adolescent Rheumatology Conference. The findings suggest that the presence of ANA—in combination with clinical features—could be useful for predicting a final diagnosis of an autoimmune rheumatological condition.

The researchers evaluated data of 1354 children seen at Great Ormond Street Hospital for Children in London, England, from January 2013 to July 2018. Among the children, the median age was 7.5 years (range, 0.1-17.5 years).

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A retrospective chart review was performed to ascertain the presence of the following clinical features at presentation: arthritis, skin involvement, eyes, central nervous system involvement, and Raynaud phenomenon.

The median follow-up was 4.8 years, with positive ANA results for the following titers: 1:160, 1:320, 1:640, 1:1280, 1:2560, and more than 1:2560. 

Results showed that a titer of 1:640 or higher was most commonly observed among more than 50% of children with an autoimmune rheumatology condition. Children with titers higher than 1:2560 were significantly more likely to receive a diagnosis of an autoimmune rheumatology condition.

The researchers evaluated the number of presenting features and correlated them with the final diagnosis. They determined that children with a connective tissue disease were more likely to have presented with 2 to 5 clinical features (P < .0001).

“This study suggests that, patients presenting with higher ANA titres and a combination of clinical features should be assessed systemically and followed-up as they may have increased risk of developing an autoimmune rheumatological condition,” the researchers concluded.

—Melinda Stevens

Reference:

Cinar OK, Foley C, Al-Hussaini A, Gilmour K, Buckland M, Al-Obaidi M. Can high ANA titre combined with clinical features predict developing autoimmune conditions in children? [abstract P24]. Rheumatology. 2019;58(suppl 4):kez414.005. https://academic.oup.com/rheumatology/article/58/Supplement_4/kez414.005/5575877. Accessed October 3, 2019.