School of Medicine and Health Sciences Poster Presentations

Title

Antinuclear Antibodies and Hidradenitis Suppurativa

Document Type

Poster

Keywords

Rheumatology; Hidradenitis; Immunology; Wound Etiology and Healing Study; Antinuclear Antibody

Publication Date

Spring 2017

Abstract

Introduction

Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory disease of apocrine sweat glands, characterized by recurrent abscessing inflammation. The pathogenesis of the condition is not well known although there may be an immunologic basis to the condition. Antinuclear antibodies result from immune system dysregulation, which can cause autoantibodies to cellular and nuclear antigens. Although it is a nonspecific test, it is known to be a highly sensitive test for diagnosis of connective tissue diseases including systemic lupus erythematosus. The purpose of this study is to explore antinuclear antibody positivity in HS.

Methods

This research was conducted through the Wound Etiology and Healing Study (WE-HEAL Study), a biospecimen and data repository approved by The George Washington University IRB (041408). All subjects gave written informed consent for longitudinal collection of their data. Age, gender, race, disease duration, smoking status, BMI, Hurley stage, Hidradenitis Sartorius Score (HSS), and active nodule counts were analyzed according to ANA positivity.

Results

In this subset of 64 HS patients, there were 10.9% who tested ANA+ at enrollment. There were no significant differences in age, gender, race, disease duration, smoking status, or baseline BMI between the ANA+ and ANA- groups.

HSS Score was higher in ANA negative patients (61.1 +/- 52.9 compared to 26.1 +/- 39.9, p=0.066). Baseline Hurley stage was significantly higher in the ANA negative group (p=0.000491) with 59.6% Hurley Stage III, compared to only 14.3% of patients Hurley Stage III in the ANA positive group. ANA negative patients had higher mean Active Nodule counts although this difference did not reach statistical significance (3.6+/-2.2 compared to 2.0+/-2.8, p=0.1963). Two patients changed from negative to positive ANA, and they received immunosuppression with TNF-α inhibitors, which are known to carry a risk of drug induced lupus.

Conclusion

ANA prevalence in the US population 12 years and older has been shown to be approximately 13.8%. HS patients who are ANA positive did not differ greatly from ANA negative patients in terms of their demographics in our study population. HS disease activity scores were higher in patients that are ANA negative. The immunologic mechanisms of HS have yet to be elucidated; however, we did not find a high prevalence of ANA positivity in this population at baseline. There were a small number of patients who developed a positive ANA in response to treatment with TNF-α inhibitors but this is a known side effect of this class of drugs.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Comments

Poster to be presented at GW Annual Research Days 2017.

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Antinuclear Antibodies and Hidradenitis Suppurativa

Introduction

Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory disease of apocrine sweat glands, characterized by recurrent abscessing inflammation. The pathogenesis of the condition is not well known although there may be an immunologic basis to the condition. Antinuclear antibodies result from immune system dysregulation, which can cause autoantibodies to cellular and nuclear antigens. Although it is a nonspecific test, it is known to be a highly sensitive test for diagnosis of connective tissue diseases including systemic lupus erythematosus. The purpose of this study is to explore antinuclear antibody positivity in HS.

Methods

This research was conducted through the Wound Etiology and Healing Study (WE-HEAL Study), a biospecimen and data repository approved by The George Washington University IRB (041408). All subjects gave written informed consent for longitudinal collection of their data. Age, gender, race, disease duration, smoking status, BMI, Hurley stage, Hidradenitis Sartorius Score (HSS), and active nodule counts were analyzed according to ANA positivity.

Results

In this subset of 64 HS patients, there were 10.9% who tested ANA+ at enrollment. There were no significant differences in age, gender, race, disease duration, smoking status, or baseline BMI between the ANA+ and ANA- groups.

HSS Score was higher in ANA negative patients (61.1 +/- 52.9 compared to 26.1 +/- 39.9, p=0.066). Baseline Hurley stage was significantly higher in the ANA negative group (p=0.000491) with 59.6% Hurley Stage III, compared to only 14.3% of patients Hurley Stage III in the ANA positive group. ANA negative patients had higher mean Active Nodule counts although this difference did not reach statistical significance (3.6+/-2.2 compared to 2.0+/-2.8, p=0.1963). Two patients changed from negative to positive ANA, and they received immunosuppression with TNF-α inhibitors, which are known to carry a risk of drug induced lupus.

Conclusion

ANA prevalence in the US population 12 years and older has been shown to be approximately 13.8%. HS patients who are ANA positive did not differ greatly from ANA negative patients in terms of their demographics in our study population. HS disease activity scores were higher in patients that are ANA negative. The immunologic mechanisms of HS have yet to be elucidated; however, we did not find a high prevalence of ANA positivity in this population at baseline. There were a small number of patients who developed a positive ANA in response to treatment with TNF-α inhibitors but this is a known side effect of this class of drugs.