[ Positivité des anticorps antinucléaires sans cible antigénique identifiée: A propos d’un cas ]
Volume 67, Issue 1, June 2023, Pages 72–74
Asmaa Farmati1, Marwane Mourchid2, Asmaa Drissi Bourhanbour3, and J. El Bakouri4
1 Laboratory of Sero-immunology, Ibn Rochd University Hospital Center, Casablanca, Morocco
2 Laboratory of Sero-immunology, Ibn Rochd University Hospital Center, Casablanca, Morocco
3 Laboratoire d’immunologie-sérologie, CHU Ibn Rochd Casablanca, Morocco
4 Laboratoire d’Immuno-sérologie, CHU Ibn Rochd, Casablanca, Maroc
Original language: French
Copyright © 2023 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Antinuclear antibodies are autoantibodies directed against cellular autoantigens. They are detected by indirect immunofluorescence technique. In case of positivity, the antigenic target must be identified. In this work we report the case of antinuclear antibody positivity without defined antigenic target. The patient was 56 years old and came to the department of internal medicine because of a worsening of her late-onset asthma, which had been followed for 3 years, with the appearance of myalgias, arthralgias, photosensitivity and dry eyes, which led to the suspicion of an autoimmune disease. Biological examinations showed an elevation of CRP and sedimentation rate, normal blood count, normal hemostasis, renal and hepatic tests were also without particularities. Immunological tests for rheumatoid factor and anti-CCP antibodies were negative. The anti-nuclear antibody test was positive on two occasions at 640 and 1280 with a homogeneous appearance. However, the complementary workup to identify antinuclear antibodies was negative: anti-native Dna antibodies, anti-soluble antigen antibodies and myositis profile. Finally, the search for anti-neutrophil cytoplasmic antibodies was positive for p- ANCA with a value greater than 1280. The diagnosis of Churg-Strauss type ANCA vasculitis was retained in our patient in view of the clinical symptoms presented and the positive immunological assessment for p-ANCA.
Author Keywords: Autoantibodies, Indirect immunofluorescence, Anti-neutrophil cytoplasm antibody, vasculitis, Churg-Strauss syndrome.
Volume 67, Issue 1, June 2023, Pages 72–74
Asmaa Farmati1, Marwane Mourchid2, Asmaa Drissi Bourhanbour3, and J. El Bakouri4
1 Laboratory of Sero-immunology, Ibn Rochd University Hospital Center, Casablanca, Morocco
2 Laboratory of Sero-immunology, Ibn Rochd University Hospital Center, Casablanca, Morocco
3 Laboratoire d’immunologie-sérologie, CHU Ibn Rochd Casablanca, Morocco
4 Laboratoire d’Immuno-sérologie, CHU Ibn Rochd, Casablanca, Maroc
Original language: French
Copyright © 2023 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Antinuclear antibodies are autoantibodies directed against cellular autoantigens. They are detected by indirect immunofluorescence technique. In case of positivity, the antigenic target must be identified. In this work we report the case of antinuclear antibody positivity without defined antigenic target. The patient was 56 years old and came to the department of internal medicine because of a worsening of her late-onset asthma, which had been followed for 3 years, with the appearance of myalgias, arthralgias, photosensitivity and dry eyes, which led to the suspicion of an autoimmune disease. Biological examinations showed an elevation of CRP and sedimentation rate, normal blood count, normal hemostasis, renal and hepatic tests were also without particularities. Immunological tests for rheumatoid factor and anti-CCP antibodies were negative. The anti-nuclear antibody test was positive on two occasions at 640 and 1280 with a homogeneous appearance. However, the complementary workup to identify antinuclear antibodies was negative: anti-native Dna antibodies, anti-soluble antigen antibodies and myositis profile. Finally, the search for anti-neutrophil cytoplasmic antibodies was positive for p- ANCA with a value greater than 1280. The diagnosis of Churg-Strauss type ANCA vasculitis was retained in our patient in view of the clinical symptoms presented and the positive immunological assessment for p-ANCA.
Author Keywords: Autoantibodies, Indirect immunofluorescence, Anti-neutrophil cytoplasm antibody, vasculitis, Churg-Strauss syndrome.
Abstract: (french)
Les anticorps antinucléaires sont des autoanticorps dirigés contre les autoantigènes cellulaires. Ils sont détectés par technique d’immunofluorescence indirecte. En cas de positivité, la cible antigénique doit être identifiée. Dans ce travail nous rapportons le cas de positivité d’anticorps antinucléaires sans cible antigénique définie. Il s’agit d’une patiente âgée de 56 ans qui vient consulter au service de médecine interne pour l’aggravation de son asthme tardif suivi depuis 3 ans avec apparition de myalgies, arthralgies, d’une photosensibilité et une sécheresse oculaire ce qui a suspecté une maladie d’origine auto-immune. Les examens biologiques ont montré une élévation de la CRP et la vitesse de sédimentation, la numération de la formule sanguine normale, le bilan d’hémostase normal, le bilan rénal et hépatique sont aussi sans particularités. Sur le plan immunologique la recherche du facteur rhumatoïde et des anticorps anti-CCP est négatif. La recherche des anticorps anti-nucléaires était positive à 2 reprises à 640 et 1280 avec un aspect homogène. Cependant le bilan complémentaire visant à identifier les anticorps antinucléaires était négatif: les anticorps anti-Dna natif, les anticorps anti-antigènes solubles et le profil myosite. Enfin, la recherche des anticorps anti-cytoplasme des neutrophiles s’est avérée positif pour les p- ANCA avec une valeur supérieure à 1280. Le diagnostic d’une vascularite à ANCA type Churg et Strauss a été retenu chez notre patiente devant la symptomatologie clinique présentée et le bilan immunologique positif aux p-ANCA.
Author Keywords: Autoanticorps, Immunofluorescence indirecte, Anticorps anti-cytoplasme des neutrophiles, vascularite, syndrome Churg-Strauss.
How to Cite this Article
Asmaa Farmati, Marwane Mourchid, Asmaa Drissi Bourhanbour, and J. El Bakouri, “Antinuclear antibody positivity without identified antigenic target: A case report,” International Journal of Innovation and Scientific Research, vol. 67, no. 1, pp. 72–74, June 2023.
