Antinuclear antibodies giving the 'multiple nuclear dots' or the 'rim-like/membranous' patterns: diagnostic accuracy for primary biliary cirrhosis.

Granito, A; Muratori, P; Muratori, L; Pappas, G; Cassani, F; Worthington, J; Guidi, M; Ferri, S; DE Molo, C; Lenzi, M; Chapman, R; Bianchi, F

Journal article

Antinuclear antibodies giving the 'multiple nuclear dots' or the 'rim-like/membranous' patterns: diagnostic accuracy for primary biliary cirrhosis.

Abstract:: BACKGROUND: Serum antinuclear antibodies giving the 'multiple nuclear dots' or the 'rim-like/membranous' patterns are frequently detected by indirect immunofluorescence on HEp-2 cells in patients with primary biliary cirrhosis. AIM: To assess the accuracy of multiple nuclear dot and rim-like/membranous antinuclear antibodies for the diagnosis of primary biliary cirrhosis. METHODS: Sera from 4371 consecutive patients referred to our laboratory were analysed under code for antinuclear antibodies testing by indirect immunofluorescence on HEp-2 cells. RESULTS: Review of the clinical records of the 4371 patients allowed identification of 101 patients with antimitochondrial antibody-positive primary biliary cirrhosis and 22 with antimitochondrial antibody-negative variant. Multiple nuclear dot and/or rim-like/membranous patterns were found in 59 (1.3%) of the 4371 patients: 31 antimitochondrial antibody-positive primary biliary cirrhosis, 17 antimitochondrial antibody-negative primary biliary cirrhosis and 11 non-primary biliary cirrhosis. The specificity for primary biliary cirrhosis of both the antinuclear antibodies pattern was 99%. Positive predictive value and likelihood ratio for a positive test were 86% (95% CI: 72.7-94) and 221 (95% CI: 91.7-544) for multiple nuclear dot, 79% (95% CI: 62.2-90.1) and 132 (95% CI: 56.8-312.7) for rim-like/membranous, respectively. CONCLUSIONS: Multiple nuclear dot and rim-like/membranous antinuclear antibodies are rare findings. Their positivity strongly suggests the diagnosis of primary biliary cirrhosis, irrespective of antimitochondrial antibody status. The high specificity for primary biliary cirrhosis makes them a useful diagnostic tool especially in antimitochondrial antibody-negative patients.

Publication status:: Published

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APA Style

Granito, A., Muratori, P., Muratori, L., Pappas, G., Cassani, F., Worthington, J., Guidi, M., Ferri, S., DE Molo, C., Lenzi, M., Chapman, R., & Bianchi, F. (2006). Antinuclear antibodies giving the 'multiple nuclear dots' or the 'rim-like/membranous' patterns: diagnostic accuracy for primary biliary cirrhosis. Alimentary Pharmacology and Therapeutics, 24(11-12), 1575–1583.

MLA Style

Granito, A, et al. “Antinuclear Antibodies Giving the 'Multiple Nuclear Dots' or the 'Rim-like/Membranous' Patterns: Diagnostic Accuracy for Primary Biliary Cirrhosis.” Alimentary Pharmacology and Therapeutics, vol. 24, nos. 11-12, 2006, pp. 1575–83.

Chicago Style

Granito, A, P Muratori, L Muratori, et al. 2006. “Antinuclear Antibodies Giving the 'Multiple Nuclear Dots' or the 'Rim-like/Membranous' Patterns: Diagnostic Accuracy for Primary Biliary Cirrhosis.” Alimentary Pharmacology and Therapeutics 24 (11-12): 1575–83.
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