SHM Converge Scientific Abstract ePoster Gallery-Utility of Positive Antinuclear Antibody Tests in the Inpatient Setting

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This study examined the value of a positive antinuclear antibody (ANA) test in hospitalized patients, since ANA can be positive in autoimmune disease but also in non-rheumatic conditions and healthy people. The authors reviewed hospital admissions from January 2017 to January 2020 for adults aged 18–80 who had a rheumatology consultation after a positive ANA at a titer of at least 1:160.<br /><br />Among 165 patients, the most common reasons ANA was ordered were interstitial lung disease (ILD), pulmonary hypertension (PH), and inflammatory arthritis. Overall, 41% of patients with a positive ANA had a rheumatic disorder (RD): 25% were newly diagnosed during the hospitalization, and 16% already had a known RD. The most common new diagnoses were systemic lupus erythematosus (SLE) and systemic sclerosis (SSc).<br /><br />Diagnostic yield varied by clinical context. RD was found in about 40–50% of patients tested for ILD or PH, and in 63% of those tested for inflammatory arthritis. However, ANA testing was sometimes used when previous results were already known or to confirm an established diagnosis.<br /><br />The authors conclude that inpatient ANA testing is most useful when there is a strong clinical suspicion for a rheumatic disease, especially SLE, SSc, ILD, PH, or inflammatory arthritis. They recommend avoiding ANA as a broad screening test in hospitalized patients.

Asset Subtitle

Ilan Schwell

Meta Tag

Author List Arundathi Jayatilleke, Ilan Schwell, Raagni Kumar, Shahrzad Abdollahi

Category Research

Concept ANA Test

Concept Positive ANA

Concept Rheumatic Disease

Concept Hospitalized Patient

Concept Clinical Suspicion

Distinguished Non-Finalist

Presenter Organization Lewis Katz School of Medicine

Presenting Author Ilan Schwell

Track Outcomes Research

Keywords

antinuclear antibody

ANA test

rheumatic disease

hospitalized patients

systemic lupus erythematosus

systemic sclerosis

interstitial lung disease

pulmonary hypertension

inflammatory arthritis

diagnostic yield

ANA Test

Positive ANA

Rheumatic Disease

Hospitalized Patient

Clinical Suspicion