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      Anti-dsDNA

      Anti-dsDNA refers to antibodies directed against double-stranded DNA

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      Description

      Anti-dsDNA refers to antibodies directed against double-stranded DNA. These antibodies are highly specific for systemic lupus erythematosus (SLE), an autoimmune disease where the immune system attacks the body's own tissues and organs.

      What is Anti-dsDNA?

      • Anti-dsDNA antibodies are autoantibodies that bind to the double-stranded DNA found in the nuclei of cells.
      • They are a hallmark of SLE and are used as a diagnostic and monitoring tool for the disease.

      Clinical Significance of Anti-dsDNA

      1. Specificity for SLE:
      • Anti-dsDNA is highly specific for SLE, meaning it is rarely present in other diseases.
      • It is considered one of the classification criteria for SLE by the American College of Rheumatology (ACR).
      1. Association with Disease Activity:
      • Elevated anti-dsDNA levels are often correlated with active disease, particularly with lupus nephritis (kidney involvement).
      • A rising titer may indicate a flare, especially involving organs like the kidneys.
      1. Prognostic Value:
      • Persistent high levels can predict complications such as nephritis or systemic inflammation.

      Testing for Anti-dsDNA

      1. Methods:
      • Enzyme-Linked Immunosorbent Assay (ELISA): Commonly used, sensitive, but less specific.
      • Farr Assay: More specific, measures high-affinity anti-dsDNA antibodies.
      • Immunofluorescence (Crithidia luciliae): Highly specific and considered the gold standard.
      1. When It’s Ordered:
      • Suspected cases of SLE with symptoms like joint pain, skin rashes (e.g., butterfly rash), and fatigue.
      • Monitoring SLE disease activity, especially in patients with renal or systemic involvement.
      1. Results Interpretation:
      • Positive Test: Strongly supports an SLE diagnosis but must be interpreted alongside clinical symptoms and other tests.
      • Negative Test: Does not exclude SLE, as not all SLE patients have anti-dsDNA antibodies.

      Symptoms Related to Anti-dsDNA Antibodies

      Anti-dsDNA contributes to the development of symptoms by forming immune complexes that deposit in tissues, causing inflammation. Common manifestations include:

      1. Renal Symptoms (Lupus Nephritis):
      • Proteinuria (protein in urine).
      • Hematuria (blood in urine).
      • Hypertension.
      1. Systemic Symptoms:
      • Fever, fatigue, and weight loss.
      1. Skin and Mucosal Symptoms:
      • Malar rash (butterfly rash on the face).
      • Photosensitivity.
      • Mouth ulcers.
      1. Joint and Muscle Symptoms:
      • Polyarthritis (joint pain and swelling).
      1. Neurological Symptoms:
      • Seizures or psychosis in severe cases.

      Management of Elevated Anti-dsDNA Levels

      1. Treatment of Active Disease:
      • Mild Disease: NSAIDs and hydroxychloroquine for joint and skin symptoms.
      • Moderate Disease: Low-dose corticosteroids and immunosuppressants (e.g., azathioprine, methotrexate).
      • Severe Disease (Lupus Nephritis or CNS Involvement):
      • High-dose corticosteroids.
      • Cytotoxic drugs like cyclophosphamide or biologics (e.g., belimumab or rituximab).
      1. Monitoring:
      • Regular anti-dsDNA titer checks, particularly during flares or when nephritis is suspected.
      • Complement levels (C3, C4) are often monitored alongside, as low levels indicate active disease.
      1. Lifestyle and Preventive Measures:
      • Sun protection to avoid UV-induced flares.
      • Avoid smoking, as it exacerbates SLE.
      • Regular follow-ups to monitor organ involvement.

      Other Conditions Associated with Anti-dsDNA

      Although primarily linked to SLE, low levels of anti-dsDNA may sometimes be seen in:

      • Chronic hepatitis.
      • Other autoimmune diseases (e.g., Sjögren's syndrome, rheumatoid arthritis).
      • Drug-induced lupus (rare).


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      Anti-dsDNA

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