Assessment of antinuclear antibodies (ANA): National recommendations on behalf of the Croatian society of medical biochemistry and laboratory medicine

Kuna, Andrea Tešija; Đerek, Lovorka; Drvar, Vedrana; Kozmar, Ana; Gugo, Katarina

doi:10.11613/bm.2021.020502

Cited by 13 publications

(13 citation statements)

References 70 publications

(75 reference statements)

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“…More recently novel ANA screening assays have been developed; some studies reporting diagnostic test data were conducted to evaluate the diagnostic performance of the novel assays 36 . This review compares the current 2 ANA screening methods by taking manual‐IIF as the gold standard, with respect to qualitative results; automated‐IIF exhibited higher accuracy than solid‐phase assays, increasing the probability of being used as a standardized alternative to the conventional manual‐IIF under the condition of increased demand for ANA testing in clinical immunology laboratories.…”

Section: Discussionmentioning

confidence: 99%

An indirect comparison of automated indirect immunofluorescence vs automated solid‐phase immunoassays for antinuclear antibody detection: A meta‐analysis and adjusted indirect comparison of diagnostic test accuracy

Zhang

2022

Int J of Rheum Dis

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Objective:The primary aim of this study was to conduct a meta-analysis to compare the diagnostic accuracy of automated indirect immunofluorescence (automated-IIF) and fully automated solid-phase immunoassays (solid-phase assays), compared with gold standard conventional manual indirect immunofluorescence (manual-IIF) for antinuclear antibody (ANA) detection.Methods: Indirect meta-comparison was performed using prospective studies reporting comparative data between automated-IIF and fully automated solid-phase assays individually to conventional manual-IIF. Diagnostic tests regarding different automated solid-phase assays and automated-IIF for ANA detection were retrieved from the Cochrane Library, PubMed, Embase, Web of Science, Chinese Biological Medicine Database (CBM), China National Knowledge Infrastructure (CNKI), and WANFANG electronic databases from their inception to January 2022. Assessment of the quality of the studies was undertaken using a second version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The investigated diagnostic indices including pooled sensitivity, pooled specificity, pooled positive likelihood ratio (PLR), pooled negative likelihood ratio (NLR), pooled diagnostic odds ratio (DOR), area under the summary receiver operating characteristic (AUC) of automated-IIF and solidphase assays, respectively. Relative diagnostic odds ratio (RDOR) was calculated to indirectly compare the diagnostic accuracy of automated-IIF and solid-phase assays.To visualize results, we provide forest plots showing the RDOR with 95% confidence intervals (CI) of the 2 methods against the "gold standard" manual-IIF by R software.Deeks' funnel was used to investigate the publication bias.Results: A total of 16 studies involving 6111 subjects were included in the analysis. The pooled sensitivity, pooled specificity, pooled PLR, pooled NLR, pooled DOR and the AUC were 0.85 (95% CI: 0.84-0.86), 0.82 (95% CI 0.81-0.84), 14.22 (95% CI 8.55-23.65), 0.06 (95% CI 0.03-0.12), 287.0 (95% CI 124.30-662.68) and 0.983 for automated-IIF respectively, and as for solid-phase assays those were 0.73 (95% CI 0.70-0.75), 0.87 (95% CI 0.85-0.89), 5.66 (95% CI 3.33-9.62), 0.30 (95% CI 0.20-0.47),

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Section: Discussionmentioning

confidence: 99%

An indirect comparison of automated indirect immunofluorescence vs automated solid‐phase immunoassays for antinuclear antibody detection: A meta‐analysis and adjusted indirect comparison of diagnostic test accuracy

Zhang

2022

Int J of Rheum Dis

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“…The selection of substantially homogenous groups of patients for participation in research studies and trials requires classification criteria, and in our study, only 15.8% of the participants agreed that they knew some classification criteria for SLE. Many SLE classification criteria have been used, such as the 1982 revised ACR criteria and its revision in 1997, the 2012 SLICC, and the latest 2019-EULAR/ACR criteria, which are the most widely followed criteria [ 5 , 22 - 24 ]. The 2019-EULAR/ACR criterion has shown high sensitivity and specificity for SLE classification compared to the ACR-1997 and SLICC-2012 criteria [ 5 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Primary Healthcare Practitioners’ Knowledge, Attitude, and Practice Toward Systemic Lupus Erythematosus in the Qassim Region, Saudi Arabia

Alrashdi¹,

Alrasheedi²,

Alkhdairi³

et al. 2022

Cureus

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The study aims to evaluate the primary healthcare practitioner's (PHCP) knowledge, attitude, and practice toward systemic lupus erythematosus (SLE) and to explore the difficulties of early referral to specialized clinics. MethodThis is a cross-sectional study conducted between February and March 2022 targeting the PHCP among the primary healthcare centers in Qassim, Saudi Arabia. The study was conducted among 203 participants who enrolled via a cluster random sampling technique depending on the survey. Qualitative categorical variables are expressed as frequencies and percentages, while continuous variables are reported as means and standard deviations (SD). The one-way analysis of variance (ANOVA) test and the independent T-test have been used to explore the relationship between participants' knowledge scores and their socio-demographic characteristics. A P-value ≤0.05 was considered statistically significant. ResultThe study found that only 4.4% of participating PHCPs had good knowledge related to SLE, while 45.8% of them had fair knowledge, and nearly half of them (49.8%) had poor knowledge. It was noted that GPs who specialized in family medicine or saw more than 40 patients each week had comparably better knowledge than others, which was statistically significant (p<0.05). The difficulty in diagnosing SLE patients was mentioned by 48.3% of the PHCPs. Family medicine consultants (p<0.001), those who worked in a tertiary care facility for more than six months (p<0.001) and those who worked in a rheumatology department (p<0.05), reported considerably better levels of comfort when treating SLE patients. ConclusionThis study found that included participants' understanding of SLE, its diagnosis, and management was inadequate. Coordination between rheumatologists and experts from many disciplines at the primary, secondary, and tertiary levels of care is critical for overcoming ambiguities and obstacles in the diagnosis and therapy of SLE patients.

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“…If the patient fulfills the criteria for SLE despite seronegative, the diagnosis should not be delayed. 6,7 We herein, report a case of a 15-year-old female diagnosed with systemic lupus erythematosus due to its rare occurrence the in pediatric age group.…”

Section: Introductionmentioning

confidence: 97%

Diagnostic Dilemma of ANA-negative Pediatric Systemic Lupus Erythematosus in a South Asian Female

Khan

Abdi

et al. 2023

Clin Med Insights Case Rep

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Background: Systemic lupus erythematosus (SLE) is an autoimmune disorder affecting multiple organs with different degrees of severity. SLE is typically diagnosed based on the presence of antinuclear antibodies (ANA) in the serum. However, seronegative SLE is rare and is diagnosed by clinicians when the patient’s ANA is negative but fulfills other diagnostic criteria. Case report: We report a case of a 15-year-old South Asian female with SLE who had negative antinuclear antibodies yet displayed the typical clinical presentations of photosensitive maculopapular rash, joint pain, alopecia, anemia, and thrombocytopenia. Clinical evaluations in conjunction with lab results were used to establish a diagnosis of ANA-negative SLE. Conclusion: ANA positivity is an entry criterion for SLE; rarely, cases of ANA-negative SLE may present. A typical clinical presentation may help determine the diagnosis in such a scenario. However, still, the physician should rule out immunodeficiency and other systemic illnesses before reaching a diagnosis of ANA-negative pediatric SLE.

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Assessment of antinuclear antibodies (ANA): National recommendations on behalf of the Croatian society of medical biochemistry and laboratory medicine

Cited by 13 publications

References 70 publications

An indirect comparison of automated indirect immunofluorescence vs automated solid‐phase immunoassays for antinuclear antibody detection: A meta‐analysis and adjusted indirect comparison of diagnostic test accuracy

An indirect comparison of automated indirect immunofluorescence vs automated solid‐phase immunoassays for antinuclear antibody detection: A meta‐analysis and adjusted indirect comparison of diagnostic test accuracy

Primary Healthcare Practitioners’ Knowledge, Attitude, and Practice Toward Systemic Lupus Erythematosus in the Qassim Region, Saudi Arabia

Diagnostic Dilemma of ANA-negative Pediatric Systemic Lupus Erythematosus in a South Asian Female

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