Anti ds-DNA Antibody (IFA) - Serum

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Antibody against double-stranded DNA.

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Anti ds-DNA Antibody (IFA) - Serum Test Information Guide

Why is it done?
- Test Purpose: Detects antibodies against double-stranded DNA (ds-DNA) using immunofluorescence assay (IFA) methodology. These antibodies are autoimmune markers that attack the body's own DNA.
- Primary Indications: Diagnosis and monitoring of Systemic Lupus Erythematosus (SLE); evaluation of autoimmune disease; assessment of lupus nephritis risk; monitoring disease activity and treatment response
- Clinical Circumstances: Patients presenting with symptoms suggestive of SLE such as joint pain, photosensitivity, malar rash, or renal involvement; follow-up testing during lupus management; evaluation of positive ANA results; suspected drug-induced lupus; recurrent miscarriages with suspected lupus
Normal Range
- Reference Values: Negative or <1:10 titer (may vary by laboratory); some laboratories report as <0.9 index or negative
- Units: IU/mL, titer ratio (1:10 or higher), or index value
- Negative Result: Absence of anti-ds-DNA antibodies; suggests absence of SLE or other autoimmune disease (though negative result does not completely rule out SLE)
- Positive Result: Presence of anti-ds-DNA antibodies; highly specific for SLE; titer levels (low, moderate, high) may correlate with disease activity
- Interpretation Guide: Normal (negative) = No anti-ds-DNA antibodies detected; Positive = Present (titer may be reported as low, moderate, or high); Very High Titers = Associated with active lupus, especially lupus nephritis
Interpretation
- Negative Anti-ds-DNA: Less likely to have SLE; however, approximately 30% of SLE patients may be seronegative for anti-ds-DNA; does not exclude other autoimmune conditions
- Low Positive Titer (1:10-1:40): May be seen in early SLE, remission, or other autoimmune diseases; requires correlation with clinical symptoms and additional laboratory findings
- Moderate Positive Titer (1:40-1:160): Consistent with active SLE; correlates with disease manifestations; higher likelihood of lupus nephritis and systemic involvement
- High Positive Titer (>1:160): Strongly indicative of active SLE; associated with increased risk of renal disease; highly specific for SLE diagnosis; suggests need for close monitoring and aggressive management
- Factors Affecting Results: Disease activity and severity; current immunosuppressive therapy; anti-malarial treatment (may lower titers); other autoimmune conditions; recent infections; pregnancy status
- Clinical Correlation: Results must be interpreted within clinical context; positive results support SLE diagnosis but require supporting clinical and laboratory evidence; titer changes may reflect disease activity; used alongside complement levels (C3, C4) and urinalysis for comprehensive assessment
Associated Organs
- Primary System Affected: Immune system dysfunction; systemic involvement affecting multiple organ systems
- Organs Commonly Involved in Positive Anti-ds-DNA: Kidneys (lupus nephritis - most serious manifestation); skin; joints; heart (pericarditis, myocarditis); lungs (pleuritis, pulmonary hemorrhage); nervous system (seizures, psychosis); blood vessels; eyes (ocular involvement)
- Associated Diseases/Conditions: Systemic Lupus Erythematosus (SLE); lupus nephritis (glomerulonephritis); drug-induced lupus; neonatal lupus; secondary lupus in overlap syndromes; rarely in other connective tissue diseases
- Potential Complications with Positive Results: Progressive renal failure and chronic kidney disease; cardiac complications including conduction abnormalities and valve disease; cerebral involvement with cognitive impairment; hematologic complications (anemia, thrombocytopenia); severe systemic inflammation; secondary infections due to immunosuppressive therapy
- Diagnostic Significance: Part of ACR/EULAR diagnostic criteria for SLE; high specificity for SLE (95-98%); particularly predictive of lupus nephritis; helps differentiate SLE from other autoimmune diseases
Follow-up Tests
- Recommended Concurrent/Follow-up Testing: ANA (Antinuclear Antibody) panel; Anti-Smith (Sm) antibodies; Complement levels (C3, C4); ESR and CRP (inflammatory markers); Complete Blood Count (CBC); Urinalysis with microscopy; Serum creatinine and eGFR; 24-hour urine protein; Lupus anticoagulant and anticardiolipin antibodies
- Further Investigation if Positive: Renal biopsy if lupus nephritis is suspected; kidney ultrasound or MRI; cardiac imaging (echocardiogram) if cardiac involvement suspected; chest X-ray for pulmonary assessment; MRI brain if neuropsychiatric symptoms present
- Monitoring Frequency: Anti-ds-DNA titer typically rechecked every 3-6 months during active disease; quarterly during maintenance therapy; more frequently during acute flares; complement levels assessed simultaneously; urinalysis monthly to assess for hematuria or proteinuria
- Complementary Testing: Anti-Ro/SSA and Anti-La/SSB antibodies (overlap syndromes); Anti-RNP antibodies; Anti-histone antibodies (drug-induced lupus); Rheumatoid factor and anti-CCP (to exclude rheumatoid arthritis); TSH and anti-TPO (autoimmune thyroiditis overlap)
- Monitoring for Treatment Response: Declining anti-ds-DNA titers indicate positive treatment response; stabilization or rising titers may suggest inadequate disease control; correlate titer changes with clinical improvement; assess in combination with complement levels for comprehensive response evaluation
Fasting Required?
- Fasting Status: No
- No Special Preparation Required: Fasting is not necessary for this serologic test; patient may eat and drink normally before collection; no dietary restrictions apply
- Collection Requirements: Blood draw during any time of day; serum sample required (usually SST gold-top tube); standard venipuncture procedure; no special handling needed beyond standard laboratory protocols
- Medications: Continue all regular medications including immunosuppressants, corticosteroids, NSAIDs, and antimalarials as prescribed; no medications need to be held or avoided; timing of blood draw is not affected by medication schedules
- Additional Patient Instructions: Remain hydrated before blood draw; wear comfortable clothing with easily accessible arms; inform phlebotomist of any bleeding disorders or anticoagulant therapy; document recent infections or medications affecting results; note timing relative to last flare or disease exacerbation

How our test process works!