Exploring the Significance of Elevated Antinuclear Antibodies in Medically Critically Ill Patients

Antinuclear antibodies (ANA) and a type of antibodies that are produced against macromolecules in cell nuclei or the cytoplasm. Indirect immunofluorescence is the most widely method to detect ANA with additional solid phase assays also being available. All the patient admitted to the ICU and had their ANA levels drawn at the SMDC within the past three years (Jan 2017 to Dec 2019) were included in the study.  In patient with multiple hospitalizations, the most recent one was considered for the study. ANA levels were detected using immunofluorescence assay technique. Between Jan 2017 and Dec 2019, 600 patients had their ANA levels drawn, out of which 78 were positive and 522 were negative. Out of the ANA positive patients, 14 (17 percent) had the values to 1:40, 29 (35 percent) had values to 1:80, 14 (17 percent) had values to 1:160, 8 (9.7 percent) had values to 1: 320, 11 (13.2 percent) had values to 1:640, 4 (4.8 percent) had values to 1:1280, 2 (2.4 percent) had values greater than >1:1280. It is concluded that in patients with RA, important differences exist between those who are ANA‐positive and ANA‐negative in terms of time to fulfillment of RA criteria and time to DMARD initiation as well as choice of initial pharmacotherapy.