From the Guidelines
Yes, infection can cause false positive double-stranded DNA (dsDNA) and anti-SS-A (Sjögren's syndrome antigen A) antibodies.
Key Points
- Infections, including bacterial 1, viral 1, and parasitic infections 1, can trigger the production of anti-dsDNA antibodies, leading to false positive results.
- The term anti-dsDNA encompasses a great diversity of antibodies with different antigenic specificities, which can target multiple and different DNA structures 1.
- The conception of anti-dsDNA as a uniform group of antibodies that work as a highly specific SLE biomarker targeting a unique form of dsDNA is incorrect 1.
- It is essential to interpret these results in the context of the patient's clinical presentation, medical history, and other laboratory findings to avoid misdiagnosis.
- A deeper knowledge of the etiopathogenic role of anti-dsDNA is necessary to determine the predictive value of anti-dsDNA with specificity and avidity for well-defined dsDNA structures 1. Some key considerations when interpreting these results include:
- The patient's symptoms and medical history
- The presence of other laboratory findings, such as anemia or elevated liver enzymes
- The type of infection or medication that may be triggering the production of these antibodies
- The use of standardized assays to determine the predictive value of anti-dsDNA with specificity and avidity for well-defined dsDNA structures 1.
From the Research
Infection and False Positive dsDNA and Anti-SS-A Antibodies
- Infections can cause false positive results for anti-double stranded DNA (dsDNA) antibodies, as seen in a study published in the Saudi medical journal 2, where 11 out of 88 non-SLE patients with positive anti-dsDNA results had infections.
- Another study published in the Journal of gastroenterology 3 found that anti-dsDNA antibodies were detected in patients with chronic liver disease, including those with autoimmune hepatitis, which can be triggered by infections.
- However, there is limited evidence on the specific relationship between infections and false positive anti-SS-A (Sjögren's syndrome antigen A) antibodies.
Conditions Associated with False Positive dsDNA Antibodies
- Rheumatological disorders, such as rheumatoid arthritis and systemic lupus erythematosus, can cause false positive results for anti-dsDNA antibodies 4, 2.
- Malignancies, such as lymphoma and thymoma, have also been associated with false positive anti-dsDNA results 2.
- Autoimmune hepatitis, a condition that can be triggered by infections, has also been linked to false positive anti-dsDNA antibodies 3.
Diagnostic Considerations
- The specificity of anti-dsDNA testing can vary depending on the test method used, with some methods showing higher specificity than others 5.
- A systematic review published in The journal of applied laboratory medicine 5 found that the Crithidia luciliae indirect immunofluorescence test (CLIFT) and fluorescence enzyme immunoassay methods were likely to be ≥ 90% specific for systemic lupus erythematosus.
- However, more studies are needed to fully demonstrate the specificity of other test methods, such as NOVA Lite, chemiluminescence immunoassays, and multiplex immunoassays 5.