Frequency and Clinical Utility of Antibodies to Extractable Nuclear Antigen in the Setting of a Negative Antinuclear Antibody Test
Authors' conclusion
Despite the higher-than-expected incidence of positive ENA in the setting of a negative ANA, the yield of newly diagnosed rheumatic diseases was low.
Study context
- Population
- Patients over 18 years old with simultaneous antinuclear antibody (ANA) and extractable nuclear antigen (ENA) testing, multicenter tertiary health network in Australia, March 19, 2011, to July 23, 20184,248 testing occasions
- Participants
- 3,484 participants
- Outcome
- Frequency of diagnosis of new ANA-associated rheumatic disease (AARD) with negative ANA and positive ENA
Methodological detailsmulticentre, 7-year, tertiary health network, 328 discordant ANA/ENA patients had data available for analysis
- Multicentre
- 7-year
- Tertiary health network
- 328 discordant ANA/ENA patients had data available for analysis
Main finding
As reported in the abstract
New ANA-associated rheumatic disease (AARD) diagnosed
17 of 279 patients
PPV
6.09%
95% CI 3.59–9.58
Observational data: associations, not effects.
Further findings
ENA positivity by ANA result
P < 0.001
- ENA positivity by ANA result: Negative ANA denominator: 1,728 tests
Overall positivity
Patients
- ANA positive
- 2,520 (59.3%)
- ENA positive
- 1,980 (46.6%)
Original publication
Frequency and Clinical Utility of Antibodies to Extractable Nuclear Antigen in the Setting of a Negative Antinuclear Antibody Test. Arthritis Care Res (Hoboken). Published 23 January 2023. doi:10.
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