"diseased controls" had. Nor is it clear as to why patients with
fibromyalgia were not included although patients with CFS were. The
results indicate that the EliA CTD Screen is not particularly useful
as a diagnostic tool for ME and CFS although the abstract does not
specifically state how CFS patients were defined or whether they had
co-morbid fibromyalgia.
Autoimmun Rev. 2011 Jun 30. [Epub ahead of print]
Detection of antinuclear antibodies by indirect immunofluorescence and
by solid phase assay.
Op de Be=E9ck K, Vermeersch P, Verschueren P, Westhovens R, Mari=EBn G,
Blockmans D, Bossuyt X.
Experimental Laboratory Immunology, Department of Medical Diagnostic
Sciences, Catholic University Leuven, Belgium.
Abstract
Testing for antinuclear antibodies is useful for the diagnosis of
systemic rheumatic diseases. Solid phase assays are increasingly
replacing indirect immunofluorescence for detection of antinuclear
antibodies. In the most recent generation of solid phase assays,
manufacturers attempt to improve the performance of the assays by
adding extra antigens.
Solid phase assay (EliA CTD Screen, Phadia, in which antibodies to 17
antigens are detected) was compared to indirect immunofluorescence for
the detection of antinuclear antibodies in diagnostic samples of 236
patients with autoimmune connective tissue diseases, in 149 healthy
blood donors, 139 patients with chronic fatigue syndrome, and 134
diseased controls.
The sensitivity of EliA CTD Screen for systemic lupus erythematosus,
systemic sclerosis, primary Sj=F6gren's syndrome, mixed connective
tissue disease, and inflammatory myopathy was 74%, 72%, 89%, 100%, and
39%, respectively.
The reactivity in blood donors, in patients with chronic fatigue
syndrome, and in diseased controls was <4%.
At an immunofluorescence cutoff that corresponded to the specificity
found with solid phase assays, the sensitivity of indirect
immunofluorescence was lower than the sensitivity of solid phase
assays.
Likelihood ratios increased with increasing antibody concentrations.
Generally, a positive test result by EliA CTD Screen had a higher
likelihood ratio for systemic rheumatic disease than a positive test
result by indirect immunofluorescence.
A negative test result by indirect immunofluorescence, however, had a
lower likelihood ratio than a negative test result by EliA CTD Screen,
indicating that the negative predictive value was higher for indirect
immunofluorescence than for EliA CTD screen.
Copyright =A9 2011 Elsevier B.V. All rights reserved.
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