Diagnostic accuracy of blood B-cell subset profiling and autoimmunity markers in Sjögrens syndrome.Report as inadecuate

Diagnostic accuracy of blood B-cell subset profiling and autoimmunity markers in Sjögrens syndrome. - Download this document for free, or read online. Document in PDF available to download.

1 LabEX IGO Immunothérapie Grand Ouest 2 CHU - BREST - Rhumato - CHRU Brest - Service de Rhumatologie 3 EA2216 - Immunologie et Pathologie 4 Service de dermatologie 5 Explorations fonctionnelles neurologiques 6 Laboratoire d-Immunologie et Immunothérapie

Abstract : The aims of this study were to evaluate the diagnostic accuracy of blood B-cell subset profiling and immune-system activation marker assays in primary Sjögren-s syndrome pSS and to assess whether adding these tools to the current laboratory item would improve the American-European Consensus Group AECG criteria. METHODS: In a single-center cohort of patients with suspected pSS, we tested the diagnostic performance of anti-SSA, antinuclear antibody ANA, rheumatoid factor RF, gammaglobulins, IgG titers, and B-cell ratio defined as Bm2 + Bm2-eBm5 + Bm5, determined using flow cytometry. The reference standard was a clinical diagnosis of pSS established by a panel of experts. RESULTS: Of 181 patients included in the study, 77 had pSS. By logistic regression analysis, only ANA ≥1:640 sensitivity, 70.4%; specificity 83.2% and B-cell ratio ≥5 sensitivity, 52.1%; specificity, 83.2% showed independent associations with pSS of similar strength. In anti-SSA-negative patients, presence of either of these two criteria had 71.0% sensitivity but only 67.3% specificity for pSS; whereas combining both criteria had 96.2% specificity but only 12.9% sensitivity. Adding either of these two criteria to the AECG criteria set increased sensitivity from 83.1% to 90.9% but decreased specificity from 97.1% to 85.6%, whereas adding both criteria in combination did not substantially modify the diagnostic performance of the criteria set. The adjunction of RF + ANA ≥1:320, as proposed in the new American College of Rheumatology ACR criteria, did not improve the diagnostic value of anti-SSA. CONCLUSIONS: Blood B-cell subset profiling is a simple test that has good diagnostic properties for pSS. However, adding this test, with or without ANA positivity, does not improve current classification criteria.

Author: Divi Cornec - Alain Saraux - Jacques-Olivier Pers - Sandrine Jousse-Joulin - Thierry Marhadour - Anne-Marie Roguedas-Contios - St

Source: https://hal.archives-ouvertes.fr/


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