TY - JOUR T1 - Antinuclear Antibodies in Children JF - The Journal of Rheumatology JO - J Rheumatol SP - 1260 LP - 1262 DO - 10.3899/jrheum.140480 VL - 41 IS - 7 AU - MICHAEL MAHLER AU - MARVIN J. FRITZLER Y1 - 2014/07/01 UR - http://www.jrheum.org/content/41/7/1260.abstract N2 - In this issue of The Journal, Sperotto, et al report on a longitudinal study of antinuclear antibodies (ANA) and chronic noninflammatory musculoskeletal pain (CNI-MSP) in schoolchildren1. Of 261 subjects, 32 children (12.3%) were included based on a positive ANA and 77 (29.5%) based on the presence of CNI-MSP. The positive ANA results were relatively equally distributed with respect to sex and pubertal status. In the ANA-positive cohort, the vast majority of subjects (92.9%) remained ANA-positive during followup and showed increased titers, but a significant association between ANA positivity and CNI-MSP was not found. In the children with CNI-MSP, the ANA prevalence increased after puberty from 13.4% to 44.8% but the increase was not associated with persistence of symptoms or the development of an autoantibody-associated rheumatic disease (AARD). These observations confirmed the results of a previous study showing a lack of a significant association between ANA positivity and CNI-MSP2. In addition, a family history of autoimmune diseases did not have a statistically significant influence on the prevalence of ANA positivity during this period. To fully understand and translate these findings into clinical practice, several aspects should be taken into consideration. It has been established that certain autoantibodies, especially ANA, predict the development of AARD3. Therefore, a positive ANA without concordant clinical manifestations might be considered a “false-positive” result, but in time it might be a clinically valid result. Therefore, before dismissing an ANA as clinically irrelevant, the specificity of the … Address correspondence to Dr. Mahler, INOVA Diagnostics Inc., 9900 Old Grove Road, San Diego, California 32131-1638, USA. E-mail: mmahler{at}inovadx.com or m.mahler.job{at}web.de ER -