VI Brazilian consensus guidelines for detection of anti-cell autoantibodies on HEp-2 cells

Abstract

Background The VI Brazilian Consensus on Autoantibodies against HEp-2 cells for determination of autoantibodies against cellular constituents on HEp-2 cells was held on September, 2019, in Fortaleza (CE, Brazil). The guidelines in this edition were formulated by the group of Brazilian experts discussing the classification of complex patterns, the classification of the nuclear discrete dots (few and multiple), the identification of the discrete fine speckled pattern (AC-4a) and improvements on the ANA report. Mainbody Sixteen Brazilian researchers and experts from universities and clinical laboratories representing the various geographical regions of Brazil participated in the meeting. Four main topics were discussed: (1) How to classify patterns with fluorescence in more than one cell compartment considering three relevant categoris: composite patterns, mixed patterns and multiple patterns; (2) The splitting of the discrete nuclear dots pattern into the multiple discrete nuclear dots (AC-6) and few discrete nuclear dots (AC-7) patterns, respectively; (3) Inclusion of a novel nuclear pattern characterized by discrete fine speckled pattern highly associated with antibodies to SS-A/Ro60, classified as AC-4a. In addition, adjustments on the Brazilian Consensus nomenclature were implemented aiming to harmonize the designation of some patterns with the International Consensus on ANA Patterns (ICAP). Furthermore, the designations of the PCNA-like pattern (AC-13), CENP-F-like pattern (AC-14) and Topo I-like pattern (AC-29) were adjusted in accordance to ICAP. Finally, there was a recommendation for adjustment in the test report in order to address the status of nuclear envelope staining. For all topics, the aim was to establish specific guidelines for laboratories and clinicians. All recommendations were based on consensus among participants. All recommendations from the V Consensus were maintained and there was relevant progress in the BCA/HEp-2 guidelines and further harmonization with ICAP. Conclusion The VI BCA/HEp-2 edition was successful in establishing important recommendations regarding the classification of complex patterns, in supporting the identification of a novel pattern within the AC-4 group and in the harmonization process with the ICAP terminology.

Extended autoantibody panel in Turkish patients with early‐stage systemic sclerosis: Coexpressions and their influences on clinical phenotypes

“…For example, in the presence of different autoantibodies that react with the same cell compartment, a single pattern may be detected in IFA, and unseen patterns may remain hidden under this pattern. 31 Anti-Ro52 was positive in 22% of the patients in our study. Anti-Ro52 can be found in a variety of autoimmune conditions, including SS, systemic lupus erythematosus, SSc, and inflammatory myositis.…”

“…However, in daily practice, some situations may not fit this simple rule, and morphological characteristics do not allow the classification as elementary patterns. For example, in the presence of different autoantibodies that react with the same cell compartment, a single pattern may be detected in IFA, and unseen patterns may remain hidden under this pattern 31 …”

“…For example, in the presence of different autoantibodies that react with the same cell compartment, a single pattern may be detected in IFA, and unseen patterns may remain hidden under this pattern. 31 …”