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    Anti-dsDNA

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

    Chhusya Bahal (Chhusya Galli), Jyatha, Thamel, Kathmandu 44600, Bagmati
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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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