Application value of serum anti-nuclear antibody fluorescence karyotype and anti-nuclear antibody spectrum detec-tion in the diagnosis of systemic lupus erythematosus in children

Yan Hong; Jia Yongping; Huang Jing; Liu Xuechao; Yuan Xiaoying; Guo Yinghui

doi:10.3969/j.issn.1671-6450.2025.01.015

Abstract：Objective To explore the application value of antinuclear antibody(ANA)and antinuclear antibody spectrum(ANAs)in the diagnosis of systemic lupus erythematosus(cSLE)in children.Methods A total of 96 children di-agnosed with SLE in the Department of Nephrology and Immunology of our hospital were selected as the experimental group,86 children with other rheumatic diseases were selected as the disease control group,and 60 healthy subjects were selected as the healthy control group.The expression of ANA and ANAs in serum was detected by indirect immunofluores-cence and immunoblotting,respectively.The positive expression was analyzed and the diagnostic efficacy of different diag-nostic methods was compared.The results of fluorescence karyotype and specific antibody spectrum were analyzed statisti-cally.Results The expression of ANA in cSLE(90.6％)was significantly higher than that in disease control group(36.0％)and healthy control group(3.3％,P＜0.05).The fluorescent karyotypes of cSLE children mainly included nuclear granular type in 21 cases(24.1％),nuclear homogeneous type in 25 cases(28.7％)and related mixed type in 41 cases(47.2％).The positive rates of nRNP/Sm,Sm,SSA,Ro-52,dsDNA,anti-nucleosome,anti-histone and anti-RIB in ANAs of cSLE children were significantly different from those of the disease control group and the healthy control group(P＜0.01).The dsDNA an-tibodies,anti-nucleosome antibodies and anti-histone antibodies were dominant in nuclear homogeneity type and related mixed type,anti-NRNP/Sm antibodies,SSA antibodies and Ro52 antibodies were dominant in nuclear particle type and relat-ed mixed type,anti-RIB antibodies were dominant in cytoplasmic particle type and related mixed type.There was general consistency between ANA and ANAs(Kappa=0.443,P＜0.05),and the sensitivity of the combined detection increased.Conclusion ANA and ANAs have their respective advantages and are correlated with each other.There is a certain corre-lation between ANA and ANAs antibody.The combined detection of ANA and ANAs can greatly improve the sensitivity and reduce the missed diagnosis rate of children with SLE,which is of great significance for the early diagnosis and timely treatment of children with cSLE.