Clinical Relevance of HEp-2 Indirect Immunofluorescent Patterns: the International Consensus on ANA Patterns (ICAP) Perspective

Overview

Journal Ann Rheum Dis

Specialty Rheumatology

Date 2019 Mar 14

PMID 30862649

Citations 116

Authors

Jan Damoiseaux

Luis Eduardo Coelho Andrade

Orlando Gabriel Carballo

Karsten Conrad

Paulo Luiz Carvalho Francescantonio

Marvin J Fritzler

Ignacio Garcia de la Torre

Manfred Herold

Werner Klotz

Wilson de Melo Cruvinel

Tsuneyo Mimori

Carlos von Muhlen

Minoru Satoh

Edward K Chan

Affiliations

Soon will be listed here.

Abstract

The indirect immunofluorescence assay (IIFA) on HEp-2 cells is widely used for detection of antinuclear antibodies (ANA). The dichotomous outcome, negative or positive, is integrated in diagnostic and classification criteria for several systemic autoimmune diseases. However, the HEp-2 IIFA test has much more to offer: besides the titre or fluorescence intensity, it also provides fluorescence pattern(s). The latter include the nucleus and the cytoplasm of interphase cells as well as patterns associated with mitotic cells. The International Consensus on ANA Patterns (ICAP) initiative has previously reached consensus on the nomenclature and definitions of HEp-2 IIFA patterns. In the current paper, the ICAP consensus is presented on the clinical relevance of the 29 distinct HEp-2 IIFA patterns. This clinical relevance is primarily defined within the context of the suspected disease and includes recommendations for follow-up testing. The discussion includes how this information may benefit the clinicians in daily practice and how the knowledge can be used to further improve diagnostic and classification criteria.

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