Intérêt clinique des anticorps antinucléaires: L'attente du rhumatologue au cours des maladies systémiques

The authors suggest a clear definition of the concept of a systemicdisease. The clinical and biological signs and the symptoms of the different systemic diseases are reviewed, with a special emphasis on the value and the type of the antinuclear antibodies (ANA). The coherence of biological results and the diagnosis of the physician is discussed. The implication of the criterion ANA+ is assessed in several systemic diseases characterized by the usual or frequent presence of AAN, particularly in systemic lupus erythematosus, drug-induced lupus, antiphospholipid syndrome (Hughes's syndrome), rheumatoid arthritis, Sjögren's syndrome, scleroderma, polymyositis, mixed connective tissue disease (Sharp's syndrome). The clinical systemic conditions with expectation of ANA- are also reviewed: adult onset Still's disease, giant cell arteritis (Horton's disease), microscopic polyangiitis, polyarteritis nodosa, Churg-Strauss angiitis, Wegener's granulomatosis, polymyalgia rheumatica, spondyloarthropathy, inherited periodic fevers.