Abstract
The International Consensus on ANA Patterns (ICAP) was initiated as a workshop aiming to thoroughly discuss and achieve consensus regarding the morphological patterns observed in the indirect immunofluorescence assay on HEp-2 cells. One of the topics discussed at the second ICAP workshop, and addressed in this paper, was the harmonization of reporting ANA test results. This discussion centered on the issue if cytoplasmic and mitotic patterns should be reported as positive or negative. This report outlines the issues that impact on two major different reporting methods. Although it was appreciated by all participants that cytoplasmic and mitotic patterns are clinically relevant, implications for existing diagnostic/classification criteria for ANA-associated diseases in particular hampered a final consensus on this topic. Evidently, a more concerted action of all relevant stakeholders is required. Future ICAP workshops may help to facilitate this action.
Highlights
Antinuclear antibodies (ANA) are important elements in the diagnosis of a variety of autoimmune diseases, especially ANA-associated rheumatic diseases (AARD) [1,2,3]
It was appreciated by all participants that cytoplasmic and mitotic patterns are clinically relevant, implications for existing diagnostic/classification criteria for ANA-associated diseases in particular hampered a final consensus on this topic
In the second Brazilian consensus on ANA in HEp-2 cells, it was decided that cytoplasmic patterns are to be considered ANA positive, but a subtitle is to be added to the report, stating that ‘‘ANA is a test that detects autoantibodies to cellular antigens— encompassing the whole cellular anatomy and all cellular structures’’ [9]
Summary
Antinuclear antibodies (ANA) are important elements in the diagnosis of a variety of autoimmune diseases, especially ANA-associated rheumatic diseases (AARD) [1,2,3]. While ANA originally were detected by indirect. Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Department of Clinical Nursing, University of Occupational and Environmental Health, Kitakyushu, Japan. Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil. Fleury Medicine and Health Laboratories, Immunology Division, Sao Paulo, Brazil
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