Autoantibodies in interstitial lung diseases

Brittany R. Stevenson, Grace A. Thompson, Monalyssa C. Watson, Christine S. Bundell, Elizabeth M. Klinken, Mina John, Fiona R. Lake, Andrew P. McLean-Tooke

Research output: Contribution to journalArticle

Abstract

The role of autoantibody testing for patients with interstitial lung disease is an evolving area. Recent guidelines recommend routine anti-nuclear antibodies, rheumatoid factor, and anti-citrullinated cyclic peptide antibody testing for patients undergoing diagnostic evaluation for interstitial lung disease, with further autoantibody testing reserved for selected cases guided by rheumatological features. Even this approach may miss patients with clinically significant autoantibodies when interstitial lung disease is the dominant or first manifestation of autoimmune disease. We retrospectively performed autoimmune serology in a clinically well characterised cohort of interstitial lung disease patients. Using stored serum, additional testing was performed to ensure all patients had complete autoantibody profiles including anti-nuclear antibodies, extractable nuclear antigen antibodies, double-stranded DNA antibodies, rheumatoid factor, anti-citrullinated cyclic peptide antibodies, anti-neutrophil cytoplasmic antibodies, and myositis antibodies. Eighty patients with interstitial lung disease, and available stored serum, were assessed. Mean age at interstitial lung disease diagnosis was 65.2 years and 42 patients were male. Positive autoimmune serology was found in 56 of 80 (70.0%) patients; the most common positive result was anti-nuclear antibodies (n=34; 42.5%). Myositis antibodies were detected in 13 of 80 (16.2%) patients. Four (5%) patients had elevated anti-citrullinated cyclic peptide antibodies, and two (2.5%) patients had detectable myeloperoxidase antibodies. Eleven (13.7%) patients with negative anti-nuclear antibodies had other significant disease associated autoantibodies. An extended panel of autoantibody testing may detect cases of connective tissue disease associated interstitial lung disease, regardless of clinical or radiological subtype, and prior to extra-pulmonary manifestations of systemic autoimmunity.

Original languageEnglish
Pages (from-to)518-523
Number of pages6
JournalPathology
Volume51
Issue number5
DOIs
Publication statusPublished - 1 Aug 2019

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Interstitial Lung Diseases
Autoantibodies
Antibodies
Anti-Idiotypic Antibodies
Myositis
Rheumatoid Factor
Serology
Antineutrophil Cytoplasmic Antibodies
Nuclear Antigens
Connective Tissue Diseases
Serum
Autoimmunity
Peroxidase
Autoimmune Diseases
Guidelines

Cite this

Stevenson, B. R., Thompson, G. A., Watson, M. C., Bundell, C. S., Klinken, E. M., John, M., ... McLean-Tooke, A. P. (2019). Autoantibodies in interstitial lung diseases. Pathology, 51(5), 518-523. https://doi.org/10.1016/j.pathol.2019.03.007
Stevenson, Brittany R. ; Thompson, Grace A. ; Watson, Monalyssa C. ; Bundell, Christine S. ; Klinken, Elizabeth M. ; John, Mina ; Lake, Fiona R. ; McLean-Tooke, Andrew P. / Autoantibodies in interstitial lung diseases. In: Pathology. 2019 ; Vol. 51, No. 5. pp. 518-523.
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Stevenson, BR, Thompson, GA, Watson, MC, Bundell, CS, Klinken, EM, John, M, Lake, FR & McLean-Tooke, AP 2019, 'Autoantibodies in interstitial lung diseases' Pathology, vol. 51, no. 5, pp. 518-523. https://doi.org/10.1016/j.pathol.2019.03.007

Autoantibodies in interstitial lung diseases. / Stevenson, Brittany R.; Thompson, Grace A.; Watson, Monalyssa C.; Bundell, Christine S.; Klinken, Elizabeth M.; John, Mina; Lake, Fiona R.; McLean-Tooke, Andrew P.

In: Pathology, Vol. 51, No. 5, 01.08.2019, p. 518-523.

Research output: Contribution to journalArticle

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Stevenson BR, Thompson GA, Watson MC, Bundell CS, Klinken EM, John M et al. Autoantibodies in interstitial lung diseases. Pathology. 2019 Aug 1;51(5):518-523. https://doi.org/10.1016/j.pathol.2019.03.007