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Test ID HIS Histone Autoantibodies, Serum

Reporting Name

Histone Autoantibodies, S

Useful For

Evaluating patients suspected of having drug-induced lupus

Specimen Type

Serum


Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.5 mL


Specimen Minimum Volume

0.35 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 21 days
  Frozen  21 days

Reference Values

<1.0 Units (negative)

1.0-1.5 Units (borderline)

>1.5 Units (positive)

Units are arbitrarily based on positive control serum.

Reference values apply to all ages.

Day(s) and Time(s) Performed

Monday, Wednesday, Friday; 3:00 p.m.

Test Classification

This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83516

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HIS Histone Autoantibodies, S 43231-0

 

Result ID Test Result Name Result LOINC Value
HIS Histone Autoantibodies, S 43231-0

Clinical Information

Histones are the most basic protein components of chromatin and their structures are highly conserved in different species. Five classes of histones called H1, H2, H2b, H3, and H4 have been described and are characterized by their molecular weights, ranging from 11 to 23 kilodalton (kD), and their content of the basic amino acids lysine and arginine.

 

Histone autoantibodies may react with any of the 5 classes of histones.(1,2) Autoantibodies to total histones are elicited by unknown mechanisms in patients treated with certain drugs, particularly procainamide, hydralazine, quinidine, alpha methyldopa, penicillamine, and isoniazid. Those patients may have signs and symptoms that resemble systemic lupus erythematosus (SLE). This disorder is identified as drug-induced lupus. Testing for autoantibodies to total histones is useful for evaluating patients suspected of having drug-induced lupus. Such patients will usually have a positive test for histone autoantibodies and a negative test for autoantibodies to double stranded DNA (dsDNA). Patients with SLE have positive tests for both types of autoantibodies.

Interpretation

A positive result for histone autoantibodies with a negative result for autoantibodies to double-stranded DNA (anti-ds-DNA) is consistent with drug-induced lupus.

 

A positive result for histone autoantibodies with a positive result for anti-dsDNA autoantibodies is consistent with systemic lupus erythematosus.

Clinical Reference

1. Borchers AT, Keen CL, Gershwin ME: Drug-induced lupus. Ann NY Acad Sci 2007;1108:166-182

2. S Vasoo. Drug-induced lupus: An update. Lupus 2006;15:757-761

Analytic Time

1 day

Method Name

Enzyme-Linked Immunosorbent Assay (ELISA)