Does ANA negative SLE exist

Does ANA negative SLE exist?

Prior to the use of the current HEp-2 assay, this occurred more frequently as the test was less sensitive and often missed anti-SS-A/Ro (52 kD and 60 kD) antibodies. The HEp-2 assay captures the vast majority of SLE; however, ANA-negative disease can rarely occur. This has been described in patients who have antibodies only against SS-A/Ro-52kD (TRIM-21) or ribosomal P, which are cytoplasmic (not nuclear) antigens. ANA-negative disease has also been described in the following scenarios:

  • • severe proteinuria (no Igs in the serum to bind with HEp-2 cells)
    • • usually ANA turns positive after treatment
  • • after cytotoxic therapy
  • • in disease remission
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