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A raised antinuclear factor (ANF) is almost always present in SLE (80-90% -
note that uraemia may render the result negative) (1).
that are associated with a positive ANF but usually of lower titre than in SLE,
- systemic sclerosis (80%)
- Sjogren's syndrome (60%)
- Still's disease (30%)
Also seen in:
- autoimmune chronic active hepatitis
- infections, infective endocarditis
- drug reactions
Occasionally a positive ANF is
found in normal elderly people.
Some patients are ANA positive but have
antibodies which recognise different sets of nuclear proteins, termed extractable
nuclear antigens (ENA)
- the commonest is anti-Ro which is usually clinically associated with photosensitivity
- low-titre ANF (titres of <=1:80) may be clinically insignificant. Higher
titres may be seen in various conditions, including RA and connective tissue
diseases, and sometimes in viral and chronic infections (2)
- 1) ARC. Connective tissue disease in primary care. Hands On 2006; 9:1-5.
- 2) ARC.The approach to the patient presenting with multiple joint pain.
Hands On 2012; 7(1):1-12.
Last reviewed 01/2018