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Related Concept Videos

Autoimmune Disorders01:29

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Related Experiment Video

Updated: May 31, 2025

Anti-Nuclear Antibody Screening Using HEp-2 Cells
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Mortality in Antinuclear Antibody-Positive Patients with and Without Rheumatologic Immune-Related Disorders: A

Uria Shani1,2, Paula David1,2,3, Ilana Balassiano Strosberg1,2

  • 1Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel.

Medicina (Kaunas, Lithuania)
|January 25, 2025
PubMed
Summary

Positive antinuclear antibody (ANA) serology is linked to a significantly higher risk of all-cause mortality, especially in individuals without rheumatological conditions. This association highlights the need for closer monitoring in ANA-positive patients.

Keywords:
anti-nuclear antibodyautoimmunityautoinflammatorymortality

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Area of Science:

  • Immunology
  • Epidemiology
  • Clinical Medicine

Background:

  • Antinuclear antibodies (ANA) are biomarkers associated with autoimmune diseases.
  • The association between ANA serology and all-cause mortality, particularly in diverse patient populations, requires further investigation.

Purpose of the Study:

  • To investigate the association between positive ANA serology and all-cause mortality.
  • To identify risk factors and specific ANA patterns associated with increased mortality.
  • To explore the impact of comorbid rheumatological immune-related disorders (RIRDs) on mortality in ANA-positive individuals.

Main Methods:

  • Retrospective cohort study of 205,862 patients from Clalit Health Services.
  • Comparison of ANA-positive (n=102,931) and ANA-negative (n=102,931) individuals aged 18 and older.
  • Multivariable Cox regression analysis to determine hazard ratios (HR) for mortality, adjusting for demographic and clinical factors.

Main Results:

  • ANA positivity was strongly associated with increased all-cause mortality (adjusted HR [aHR] 4.62).
  • Significant mortality predictors included male gender, older age at testing, and Jewish ethnicity.
  • Specific ANA patterns, such as mitochondrial and DFS-AC2, showed very high mortality prediction (aHRs 36.14 and 29.77, respectively).
  • ANA-positive patients with RIRDs had a higher survival rate (aHR 0.9) compared to those without RIRDs.

Conclusions:

  • Positive ANA serology is a significant independent predictor of increased all-cause mortality.
  • The association is particularly pronounced in individuals without diagnosed rheumatological conditions.
  • Findings suggest ANA positivity may indicate underlying occult conditions like malignancies or cardiovascular disease, warranting enhanced surveillance.