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RACCOMANDAZIONI E LINEE GUIDA   

La Rivista Italiana della Medicina di Laboratorio 2019 Dicembre;15(4):294-9

DOI: 10.23736/S1825-859X.19.00043-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: Italian

Updating the Italian Society of Clinical Pathology and Laboratory Medicine guidelines on the use of autoantibody tests in the diagnosis and monitoring of systemic rheumatic autoimmune diseases: analytical methods for the screening of antibodies to cellular antigens (ANA)

Luigi CINQUANTA 1 , Maria INFANTINO 2, Mariangela MANFREDI 2, Massimo DAVES 3, Antonella RADICE 4, Danilo VILLALTA 5, Maria Concetta SORRENTINO 6, Brunetta PORCELLI 7, Lucia TERZUOLI 7, Marcello BAGNASCO 8, Ignazio BRUSCA 9, Nicola BIZZARO 10, a nome del Gruppo di Studio in Autoimmunologia della Società Italiana di Patologia Clinica e Medicina di Laboratorio

1 Laboratorio Centralizzato SDN Spa, Gruppo SYNLAB, Pagani, Salerno, Italia; 2 Laboratorio Immunologia Allergologia, Ospedale San Giovanni di Dio, Firenze, Italia; 3 Servizio Interaziendale di Immunoematologia e Trasfusionale, Ospedale di Bolzano, Bolzano, Italia; 4 UOC Microbiologia e Virologia, Presidio Ospedaliero San Carlo Borromeo, Milano, Italia; 5 SSD Immunologia e Allergologia, Presidio Ospedaliero S. Maria degli Angeli, Pordenone, Italia; 6 Dipartimento di Medicina di Laboratorio e Biotecnologie Avanzate, Laboratorio di Patologia Clinica, Microbiologia e Virologia, Palermo, Italia; 7 UOC Laboratorio Patologia Clinica, Policlinico S. Maria alle Scotte, AOU Senese, Siena, Italia; 8 Dipartimento di Medicina Interna e Specialità Mediche (DIMI), Università di Genova, Genova, Italia; 9 Unità Operativa Complessa di Patologia Clinica, Ospedale Buccheri La Ferla Fatebenefratelli, Palermo, Italia; 10 Laboratorio di Patologia Clinica, Ospedale San Antonio, Azienda Sanitaria Universitaria Integrata di Udine, Tolmezzo, Udine, Italia



In view of the evolution of technologies and of the evidence produced in recent years on new analytical methods for the screening of antinucleocytoplasmic antibodies (ANA), the Study Group on Autoimmunology of the Italian Society of Clinical Pathology and Laboratory Medicine (SIPMeL) has deemed appropriate to update its 2015 guidelines on the use of antibody tests in the diagnosis and monitoring of rheumatic autoimmune diseases. Actually, systematic reviews and meta-analyses have shown that new recently developed solid-phase assays for the screening of ANA are able to provide overall diagnostic performance that are equivalent, or even better, than those provided by the indirect immunofluorescence method on HEp-2 cells (IIF HEp-2). However, since neither the IFI HEp-2 method nor the solid phase methods alone are capable of identifying all subjects with connective tissue disease and since in the presence of a positive result of both tests the probability of connective tissue disease is much higher compared to the positivity of a single test, it is recommended that the new solid-phase methods are associated with the IIF HEp-2 method in order to ensure higher sensitivity and specificity to the ANA screening test.


KEY WORDS: Guideline; Connective tissue diseases; Fluorescent antibody technique, indirect

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