236 Anti-nuclear antibody pattern and clinical manifestation presentation in systemic lupus erythematosus

Background and aims Anti-nuclear antibody (ANA) pattern analysis by immunofluorescence microscopy remains an important diagnostic tools for Systemic Lupus Erythematosus (SLE) in Indonesia. Although the utilisation of ANA pattern are used by physician to diagnosed SLE, there are very sparse study to explain on SLE clinical presentation and ANA pattern in Indonesia. This study was compiled to determined ANA pattern and clinical manifestation presentation in ANA positive patients. Methods This study was an observational cross-sectional study in Hasan Sadikin General Hospital Bandung, 217 patients that had satisfied American College of Rheumatology (ACR) Criteria (1997) and ANA pattern were positive when diagnosed with SLE. Data was acquired from “RSHS Lupus Registry” database. Results The study population consist of 217 patients, whom 208 patients (96%) were female and 206 patients (96%) were Sundanese (median age was 33, ranging from age 14 to 62 years), had Speckled ANA pattern (S-ANA) 98 patients (45%), Homogenous ANA Pattern (H-ANA) 63 patients (29%), Nucleolar ANA Pattern (N-ANA) 23 patients (11%), Speckled-Nucleolar ANA Pattern (SN-ANA) 18 patients (8%), and other staining patterns 15 patients (7%).The majority of clinical manifestation in S-ANA and H-ANA patients were haematological involvement with 69 patients (70%) and 42 patients (67%) respectively, and N-ANA and SN-ANA were malar rash with 20 patients (87%), and 13 patients (72%) respectively. Conclusions The most frequent ANA pattern among SLE patients in this study is S-ANA pattern. The most common clinical presentation found is haematological involvement in S-ANA and H-ANA and malar rash in N-ANA and SN-ANA.