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Value-added reporting of antinuclear antibody testing by automated indirect immunofluorescence analysis

  • Sofie Schouwers , Myriam Bonnet , Patrick Verschueren , René Westhovens , Daniel Blockmans , Godelieve Mariën and Xavier Bossuyt EMAIL logo
Published/Copyright: November 13, 2013
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Clinical Chemistry and Laboratory Medicine
From the journal Clinical Chemistry and Laboratory Medicine Volume 52 Issue 4

Abstract

Background: Automated systems for antinuclear antibody analysis are being introduced. The aim was to evaluate whether automated quantitative reading of fluorescence intensity is clinically relevant and allows for value-added reporting of test results.

Methods: Consecutive samples (n=260) were used to correlate fluorescence intensity with end-point titer. Moreover, 434 samples from controls (150 healthy blood donors, 150 chronic fatigue syndrome, and 134 diseased controls) and 252 samples (obtained at diagnosis) from patients with systemic rheumatic diseases were screened for antinuclear antibodies (1:80) on HEp-2 cells using NOVA View®, and likelihood ratios were calculated for fluorescence intensity result intervals.

Results: There was a significant correlation between end-point titer and fluorescence intensity. Likelihood ratios for a systemic rheumatic disease increased with increasing fluorescence intensity. The likelihood ratio for a systemic rheumatic disease was 0.06, 0.18, 0.51, 5.3, and 37.5 for a fluorescence intensity of ≤66, 67–150, 151–300, 301–1000, >1000, respectively. A range of 31%–37% of the patients with Sjögren’s syndrome, systemic sclerosis or systemic lupus erythematosus had fluorescence intensities >1000.

Conclusions: Estimation of fluorescence intensity by automated antinuclear antibody analysis offers clinically useful information. Likelihood ratios based on fluorescence intensity test result intervals aid with the interpretation of automated antinuclear antibody analysis and allow value-added reporting.

Keywords: antinuclear antibodies; automation; indirect immunofluorescence; likelihood ratio
Corresponding author: Xavier Bossuyt, Laboratory Medicine, University Hospitals Leuven and Experimental Laboratory Immunology, Department of Microbiology and Immunology, KU Leuven, Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium, Phone: +32 16 347009, Fax: +32 16 347931, E-mail:

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Received: 2013-7-31
Accepted: 2013-10-13
Published Online: 2013-11-13
Published in Print: 2014-04-01

©2014 by Walter de Gruyter Berlin/Boston

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https://doi.org/10.1515/cclm-2013-0610
Keywords for this article
antinuclear antibodies; automation; indirect immunofluorescence; likelihood ratio

Articles in the same Issue

  1. Masthead
  2. Masthead
  3. Editorials
  4. Inflammatory bowel diseases: where we are and where we should go
  5. Thrombophilia testing. Useful or hype?
  6. Reviews
  7. Inflammatory bowel diseases: from pathogenesis to laboratory testing
  8. Crohn’s disease specific pancreatic antibodies: clinical and pathophysiological challenges
  9. Point/Counterpoint
  10. The utility of thrombophilia testing
  11. The futility of thrombophilia testing
  12. Genetics and Molecular Diagnostics
  13. Identification of an 18 bp deletion in the TWIST1 gene by CO-amplification at lower denaturation temperature-PCR (COLD-PCR) for non-invasive prenatal diagnosis of craniosynostosis: first case report
  14. General Clinical Chemistry and Laboratory Medicine
  15. Agreement of seven 25-hydroxy vitamin D3 immunoassays and three high performance liquid chromatography methods with liquid chromatography tandem mass spectrometry
  16. First trimester pregnancy-associated plasma protein A and human chorionic gonadotropin-beta in early and late pre-eclampsia
  17. S100B blood level measurement to exclude cerebral lesions after minor head injury: the multicenter STIC-S100 French study
  18. NGAL, L-FABP, and KIM-1 in comparison to established markers of renal dysfunction
  19. Value-added reporting of antinuclear antibody testing by automated indirect immunofluorescence analysis
  20. Cardiovascular Diseases
  21. A fit-for-purpose approach to analytical sensitivity applied to a cardiac troponin assay: time to escape the ‘highly-sensitive’ trap
  22. Diabetes
  23. A simple and precise method for direct measurement of fractional esterification rate of high density lipoprotein cholesterol by high performance liquid chromatography
  24. Infectious Diseases
  25. Detection of unamplified HCV RNA in serum using a novel two metallic nanoparticle platform
  26. Increased plasma arginase activity in human sepsis: association with increased circulating neutrophils
  27. Corrigendum
  28. The relationship between estimated average glucose and fasting plasma glucose
  29. Letter to the Editors
  30. The obsessive-compulsory clinical pathologist
  31. Prism effect of specimen receiving – generation of fundamentals for the smooth progress of analytical processing
  32. Preanalytical errors: the professionals’ perspective
  33. Corrected reports in laboratory medicine in a Chinese university hospital for 3 years
  34. Comparison of an enzymatic assay with liquid chromatography-pulsed amperometric detection for the determination of lactulose and mannitol in urine of healthy subjects and patients with active celiac disease
  35. Effect of freezing-thawing process on neuron specific enolase concentration in severe traumatic brain injury sera samples
  36. Undetected creatinine levels
  37. The effect of centrifugation on three urine protein assays: benzethonium chloride, benzalkonium chloride and pyrogallol red
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