TNF and drug-induced lupus erythematosus: In patients with IBD, ANA positivity has also been observed both as part of the disease itself and in relation to therapy, particularly anti-tumor necrosis factor (anti-TNF) treatment, which is associated with ANA positivity in 20–45% of cases and the development of lupus-like syndrome (LLS) in up to 5% (Vaglio et al., 2018).