Letter to the Editor
Usefulness of assessment of antinuclear antibodies in pleural effusion for diagnosis of lupus pleuritis
Utilidad de los anticuerpos antinucleares en el diagnóstico de la pleuritis lúpica
José Luis Callejas Rubio
, Raquel Ríos Fernández, Manuela Moreno Higueras, Norberto Ortego Centeno
Corresponding author
Unidad de Enfermedades Sistémicas, Hospital Universitario San Cecilio, Granada, Spain
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In the cohort of 1000 patients from the European Working Party on Systemic Lupus Erythematosus, the prevalence of serositis, including pleurisy, pericarditis, or both, when the diagnosis of SLE was conducted was 17 and 36% during follow-up.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> The causes of PE in patients with SLE may be multiple. In a case series of 119 patients with SLE with 127 episodes of PE, 52% were considered to have lupus aetiology, 9% to be of tuberculous origin, 7% parapneumonic, 15% were transudate and 17% undetermined.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> From a practical point of view, it would be interesting to have some marker that would help diagnose the cause of PE in patients already diagnosed with SLE, or in patients who present symptoms of PE when their medical history and/or laboratory tests suggest SLE. In this sense, a determination of ANA at titres of more than 1/160 in the PF and/or an ANA PF/serum ratio of >1 may help in differential diagnosis.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">6,7</span></a> In a prospective study of 54 patients with PD (12 with lupus origins, 7 parapneumonic, 26 neoplastic and 9 transudate) the sensitivity and specificity of the ANA at titres >1/160 in the PF and the ratio ANA PF/serum >1 were determined. ANA >1/160 was observed in 11/12 patients with SLE and in 4/42 patients without SLE; sensitivity to lupus pleuritis was 91.67% and specificity of 83.33% when compared to all other PE, 90.91% when compared with exudates (exudative and neoplastic) and 55.56% when compared with transudate. Using the PF/serum ratio, sensitivity decreased to 75 and 78.57%, respectively. The authors conclude that an ANA titre >1/160 in PF is a specific diagnostic biomarker of PE in patients with SLE.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We think that in selected patients, determination of ANA in the PF can be of great help in diagnosing the aetiology of PE.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Callejas Rubio JL, Ríos Fernández R, Moreno Higueras M, Ortego Centeno N. Utilidad de los anticuerpos antinucleares en el diagnóstico de la pleuritis lúpica. Med Clin (Barc). 2016;146:e37.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contribución del análisis del líquido pleural al diagnóstico de los derrames pleurales" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Ferreiro" 1 => "M.E. Toubes" 2 => "L. 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