Korean J Nephrol.
1999 Sep;18(5):815-819.
A Case of Antinuclear Antibody(ANA) Negative Lupus Nephritis
Abstract
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Systemic lupus erythematosus is a multisystemic autoimmune disease in which the kidneys
are frequently involved. Clinical diagnosis of SLE is based on the criteria of American
Rheumatism Association (ARA). A few cases who were classified as SLE by the ARA criteria
but were antinuclear antibody (ANA)-negative have been reported. It was reported that
critical factor in ANA positivity is the choice of substrate. It is generally accepted
that the cultured cell of human origin, especially HEP-2 cell, is better than tissue
section or animal cells. Thus, the ANA test is negative only in approximately 2M of SLE
patients when human tissue culture cells are used as substrate. We report a 25-year-old man
admitted to our hospital because of generalized edema. He was found to have active lupus
nephritis(WHO class IV), photosensitivity and pancytopenia. The result of FANA test which
used HEP-2 cell as substrate was repeatedly negative, but anti-ds DNA and anti-Ro antibody
were positive.