Objective: To analyze the occurrence of anti-double-stranded DNA (dsDNA) IgG antibody in SLE (systemic lupus erythematosus) and non-SLE patients and the efficacy of combined use of ELISA and CLIFT (crithidia luciliae immunofluorescence test) in detection of anti-dsDNA IgG antibody for diagnosis of SLE. Methods: The clinical data of 4 726 patients undergoing anti-dsDNA IgG antibody detection by ELISA and 830 of them receiving CLIFT were collected. Receiver operating characteristic curve (ROC) was used to evaluate the performance of each or combined use of the two in detection of anti-dsDNA IgG antibody for the diagnosing of SLE. Results: Among the 4 726 patients tested by ELISA, 398 cases were anti-dsDNA IgG antibody positive. Of them 183 patients were diagnosed as SLE (46.0%). The non-SLE patients included liver disease (28.4%), other connective tissue diseases (7.5%), hematological disease(5.3%) and respiratory di-sease(3.8%). For 830 cases undergoing CLIFT, 134 cases were anti-dsDNA IgG antibody positive, and 94% of them were diagnosed as SLE; the non-SLE patients included 3 cases of autoimmune liver disease, 1 case of liver cirrhosis, 1 case of nephritis, 1 case of psoriasis and 1 case of anti-phospholipid syndrome. In the cohort of 830 patient with both detection of anti-dsDNA IgG antibody by both ELISA and CLIFT, 197 patients were diagnosed as SLE, and 633 patients diagnosed as non-SLF. ELISA had a sensitivity of 74.6% and a specificity of 92.9%, while CLIFT had a specificity of 98.7% and a sensitivity of 64%. The combined detection by ELISA and CLIFT could significantly improve the efficacy of diagnosing SLE, with the highest AUC of 0.8 690. Conclusions: When ELISA is applied alone for detection of anti-dsDNA IgG antibody,a high false positivity should be paid attention to. The detection of anti-dsDNA IgG antibody by both ELISA and CLIFT could significantly improve the diagnostic efficacy for SLE than by CLIFT alone.
GE Jianhua, GONG Wen, SHI Xinming, GONG Huiyun, MA Longxin, ZHOU Jinfeng, SHI Hui
. Value of combining ELISA and CLIFT in detection of anti-dsDNA IgG antibody for diagnosis of systemic lupus erythematosis[J]. Journal of Diagnostics Concepts & Practice, 2018
, 17(06)
: 658
-663
.
DOI: 10.16150/j.1671-2870.2018.06.007
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