Clinical and immunological profiles of antinuclear antibody positivity in chronic spontaneous urticaria: a case-control study
Archives of Dermatological Research, cilt.318, sa.1, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 318 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00403-026-04826-x
- Dergi Adı: Archives of Dermatological Research
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Chronic spontaneous urticaria, Autoimmunity, Antinuclear antibody, Extractable nuclear antigen, Inflammation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Chronic spontaneous urticaria (CSU) is an immunologically diverse condition where autoimmune mechanisms frequently drive disease expression. However, the clinical significance of antinuclear antibody (ANA) positivity remains incompletely understood. This study aimed to determine the prevalence of ANA and extractable nuclear antigen (ENA) positivity, characterize ANA indirect immunofluorescence (IIF) patterns and titers, and evaluate their clinical and laboratory associations in patients with CSU. This retrospective study included 554 adult patients with CSU. ANA positivity was identified in 87 patients and compared with a larger ANA-negative reference cohort (n = 261). Clinical characteristics, thyroid autoantibodies, inflammatory markers, and inflammatory indices were evaluated. Subgroup analyses were performed according to ANA titer level, ANA pattern, and ENA status. ANA positivity was detected in 15.7% (87/554) of patients. ENA positivity was identified in 21 patients (3.8% of the total cohort; 24.1% of ANA-positive patients). The dense fine speckled (DFS) pattern was the most common ANA pattern (34.5%). ANA-positive patients exhibited significantly higher anti-thyroid peroxidase (anti-TPO) levels (p = 0.007) and a higher frequency of anti-TPO positivity (p = 0.012) than ANA-negative patients. No significant differences were observed in disease duration, Urticaria Control Test scores, antihistamine treatment intensity, omalizumab response, total IgE levels, NLR, or SII according to ANA status. Higher ANA titers were associated with increased ENA positivity (p = 0.047). Patients with a DFS pattern demonstrated significantly higher NLR (p = 0.011), SII (p = 0.018), and ENA positivity rates (p < 0.001) compared with non-DFS patterns. ENA-positive patients exhibited higher CRP levels than ENA-negative patients (p = 0.023). ANA positivity in CSU is primarily associated with thyroid autoimmunity rather than disease severity or treatment response. Higher ANA titers and the DFS pattern identify subgroups with enhanced autoantibody reactivity and distinct inflammatory characteristics. These findings support the immunologic heterogeneity of CSU and highlight the need for prospective studies to clarify the biological and clinical implications of ANA-associated features.