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Poster Presentations
P12 Sensitivity differences in ELISA versus EliA for detecting anti-dsDNA antibodies: awareness for the clinician
  1. Anna Kohn1,
  2. Maudi de Jong1,
  3. Merlijn van den Berg1,
  4. Arjan Kwakernaak2,
  5. Ester van Leeuwen3,
  6. Arianne Brandsma3 and
  7. Dieneke Schonenberg-Meinema1
  1. 1Dept. of Pediatric Immunology, Rheumatology and Infectious Diseases. Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, The Netherlands
  2. 2Dept. of Internal Medicine, Dept. of Clinical Immunology, Allergy and Nephrology, Amsterdam UMC, University of Amsterdam, The Netherlands
  3. 3Laboratory of Medical Immunology, Amsterdam UMC, University of Amsterdam, The Netherlands

Abstract

Objective Heterogeneity among clinical presentation can cause difficulties when diagnosing SLE. One of the most specific immunologic criteria for this disease are anti-dsDNA antibodies. However, to detect these autoantibodies, different test methods are offered. This study will compare sensitivity of ELISA and EliA by synchronous testing in SLE patients.

Methods Between March and August 2022 samples from (suspected) SLE patients, undergoing anti-dsDNA testing, were simultaneously measured by dsDNA/nucleosome ELISA (positive IU/ml >100) and dsDNA EliA (positive > 15 IU/ml). SLICC 2012 classification criteria were used to include SLE patients. Clinical data including clinical SLEDAI-2K were retrospectively retrieved from medical records.

Results Out of 163 tested patients, 143 SLE patients were eligible for study analysis. Demographic characteristics are summarized in table 1. Sensitivity was 88.4% for ELISA versus 63.0% in EliA (McNemar. p<0.001). Of 13/14 patients with EliA+/ELISA- discrepancy (median SLEDAI 0.5), ELISA had been positive in the past. Median SLEDAI was higher for patients with EliA-/ELISA+ discrepancy (see table 2).

Conclusions In our SLE cohort, there was a striking difference in sensitivity between anti-dsDNA test results (mainly EliA-/ELISA+ discrepancy) despite active disease in these patients. We hypothesize that this might be explained by the presence of anti-nucleosome antibodies, which can be detected by dsDNA/nucleosome ELISA or ENA-immunoblot. Clinicians should be aware of lower sensitivity (higher chance of false negatives) in EliA when interpreting anti-dsDNA test results.

View this table:
Abstract P12 Table 1

Demographic characteristics

View this table:
Abstract P12 Table 2

EliA vs. ELISA test results and median SLEDAI (IQR) per subgroup

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This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/lupus-2024-el.66

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