Comparison of Tests for Systemic Lupus Erythematosus Diagnosis and Disease Monitoring

Systemic lupus erythematosus (SLE) is characterized by autoantibody production, with anti-dsDNA antibodies (anti-dsDNA) being a key indicator for SLE diagnosis and disease monitoring. A new study compared the results of two different tests that measure anti-dsDNA, an enzyme immunoassay (EIA, a blood or urine analysis that can help diagnose many infections and inflammatory conditions) and the Crithidia luciliae immunofluorescence test (CLIFT, an intensive technique that requires fluorescence microscopy and slide interpretation). Each test produced inconsistent results. 

Anti-dsDNA is detected using various assessment methods that look at immune response to native DNA, but there is not a specific test that is considered the “gold standard.” 

207 people (107 with SLE; 100 with lupus nephritis, LN) were examined and each person’s anti-dsDNA was tested at least once by both EIA and CLIFT. A total of 586 paired results were collected with 64% of the results in agreement, but 36% differed. Researchers also looked at the differences between those with SLE and LN and found out that the type of lupus also influenced the results. EIA positivity associated with LN less often than CLIFT positivity. Ultimately, researchers found disagreement between EIA and CLIFT positivity is common, happening in a fifth of participants. 

Because lupus is a difficult disease to diagnose, accurate diagnostic testing is important in reducing the time to diagnosis. This study highlights the importance of using multiple tests for diagnosis and routine monitoring of disease activity. Learn more about lab tests for lupus.

Read the study