Repeat Testing of Antibodies and Complements in Systemic Lupus Erythematosus: When Is It Enough?

Prospective SLE cohort study (n=130) of serial anti-ENA, anti-dsDNA, and complement testing. Finds anti-ENA rarely changes and is costly to retest; cites evidence that repeat ANA after positivity is not helpful for monitoring disease activity, while anti-dsDNA/complements fluctuate more. Candidate notes: Evidence cited: once ANA is positive, there is no value in serial ANA measurements for monitoring. 89.4% of patients had no change in anti-ENA screen from first test; 3.3% negative to positive and 7.3% positive to negative over follow-up. After a single anti-ENA test, ~3.9% of negatives and ~4.2% of positives changed on the next test; frequencies fell after repeated consistent results. Authors conclude routine repeating of anti-ENA is unnecessary given high cost and lack of evidence changes affect management. Anti-dsDNA and complements change more often after abnormal results and are used for disease-activity monitoring, unlike ANA/ENA. Limits noted in the record: Single-center observational study; did not assess clinical impact of ENA changes; ANA serial utility cited from prior guidelines rather than newly measured here. A positive ANA is not a diagnosis. Claims in this record are not verified.

A positive ANA is not a diagnosis. Claims in this record are not verified.

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