A comparison between the Farr radioimmunoassay and a new automated fluorescence immunoassay for the detection of antibodies against double stranded DNA in serum - PubMed (original) (raw)

Comparative Study

A comparison between the Farr radioimmunoassay and a new automated fluorescence immunoassay for the detection of antibodies against double stranded DNA in serum

R H W M Derksen et al. Ann Rheum Dis. 2002 Dec.

Abstract

Objective: To compare test characteristics of the Farr radioimmunoassay and an automated fluorescence immunoassay (ELIA dsDNA test) for the diagnosis of systemic lupus erythematosus (SLE).

Methods: A cross sectional study comprising 440 samples from 440 patients, sent to the laboratory over a three month period for anti-dsDNA testing. Chart review was performed, blinded for test results, to count for each patient the number of American College of Rheumatology criteria for the classification of SLE that were fulfilled. At least four criteria were met by 248 (56%) patients (SLE), one to three criteria by 77 (18%) (lupus-like disease, LLD), and no criterion by 115 (26%) (non-SLE/non-LLD). Results from serum samples from the non-SLE/non-LLD and SLE groups were used to calculate receiver operating characteristic curves.

Results: For the Farr assay, specificities of 95% and 99% corresponded to sensitivities of 72% and 56% respectively. For the ELIA dsDNA test these levels of specificity corresponded to sensitivities of 44% and 17% respectively.

Conclusions: The Farr radioimmunoassay is superior to the ELIA dsDNA test for identifying patients with SLE.

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Figures

Figure 1

Prevalence of ACR criteria for the classification of systemic lupus erythematosus (SLE) in 77 patients with lupus-like disease (LLD) and 249 patients with SLE. Numbers on the x axis represent individual criteria. 1, Butterfly rash; 2, chronic discoid lupus (CDLE); 3, photosensitivity; 4, oropharyngeal ulcers; 5, arthritis of at least two joints; 6, anti-dsDNA antibodies (any assay, any time); 7, nephritis; 8, serositis; 9, psychosis and/or epilepsy; 10, haemolytic anaemia, leucocytopenia, and/or thrombocytopenia; 11, ANA.

Figure 2

Results with the Farr assay and ELIA dsDNA test in IU/ml for the patients who were non-SLE/non-LLD (n=115, panel A), patients with LLD (n=77, panel B), and those with SLE (n=248, panel C). The results for the Farr assay are shown in panels A, B and C on the y axis; the y axis in panels B and C has a log scale. Panel D depicts the ROC curve for the Farr assay (continuous line) and ELIA dsDNA test (dotted line). Circles 1 and 2 correspond to cut off points for the Farr assay of 6 IU/ml and 12 IU/ml, respectively. These cut off points result in 95% and 99% specificity, respectively. Circles 3 and 4 correspond to cut off points with the ELIA dsDNA test of 19 IU/ml and 84 IU/ml, respectively. These cut off points have a specificity of 95% and 99%, respectively.

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A comparison between the Farr radioimmunoassay and a new automated fluorescence immunoassay for the detection of antibodies against double stranded DNA in serum - PubMed (original) (raw)