Double-stranded (ds, native) DNA (dsDNA) antibodies of the IgG class are an accepted criterion (American College of Rheumatology) for the diagnosis of systemic lupus erythematosus (SLE). dsDNA antibodies are detectable in approximately 85% of patients with untreated SLE, and are rarely detectable in other connective tissue diseases. Weakly-positive results caused by low-avidity antibodies to dsDNA are not specific for SLE and can occur in a variety of diseases.
Testing for IgG antibodies to dsDNA is indicated in patients who have a positive test for antinuclear antibodies (ANA) along with signs and symptoms that are compatible with the diagnosis of SLE. If the ANA test is negative, there is no reason to test for antibodies to dsDNA.
The levels of IgG antibodies to dsDNA in serum are known to fluctuate with disease activity in lupus erythematosus, often increasing prior to an increase in inflammation and decreasing in response to therapy.
A high level of anti-dsDNA in the blood is strongly associated with lupus and is often significantly increased during or just prior to a flare-up. When the anti-dsDNA is positive and you have other clinical signs and symptoms associated with lupus, it means that you likely have lupus. This is especially true if an anti-Sm test is also positive.
In the evaluation of someone with lupus nephritis, a high level (titer) of anti-dsDNA is generally associated with ongoing inflammation and damage to the kidneys.
The anti-dsDNA test helps diagnose lupus if you have a positive result on a test for ANA and have clinical signs and symptoms that suggest lupus.
Typically, an ANA test is the first test performed to evaluate if you have an autoimmune disorder. While a positive ANA test is seen in about 95% of lupus cases, it may be seen in many other conditions as well. The anti-dsDNA test is fairly specific for lupus but only 65-85% of people with lupus may be positive so a negative anti-dsDNA does not rule out lupus.
If you have a positive ANA, an anti-dsDNA test may be used to distinguish lupus from other autoimmune disorders that have similar signs and symptoms.
Depending upon clinical signs and the health care practitioner’s suspicions, other autoantibodies may also be ordered to help distinguish between, and rule out, other autoimmune disorders. Examples include tests for histone antibody (drug-induced lupus) and antiphospholipid antibodies.
The anti-dsDNA test may be used to assess disease activity if you have been diagnosed with lupus. Those with lupus often have flare-ups in which symptoms worsen and then subside. An increased anti-dsDNA level may be seen prior to and during these flare-ups.
Examples of some signs and symptoms of lupus include:
- Muscle pain
- Arthritis-like pain in one or more joints (but no or little joint damage)
- Red rash that frequently resembles a butterfly across the nose and cheek areas (malar rash)
- Low-grade fever
- Persistent fatigue, weakness
- Skin sensitivity to light
- Hair and weight loss
- Numbness or tingling in the hands or feet
- Inflammation and damage to organs and tissues, including the kidneys, lungs, heart, lining of the heart, central nervous system, and blood vessels.
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