Appropriateness in anti-nuclear antibody testing: From clinical request to strategic laboratory practice

N. Bizzaro¹, A. Wiik²

¹Nicola Bizzaro, MD, Laboratory of Clinical Pathology, Ospedale Civile, San Doná di Piave (VE), Italy; ²Allan Wiik, MD, Director, Department of Autoimmunology, Statens Seruminstitut, Copenhagen, Denmark.

ABSTRACT
As a result of rapid changes in laboratory technology, clinical behaviour and patients' expectations, along with limited economic resources, there is a greater requirement for an appropriate use of autoantibody testing. We examine the various aspects and the most controversial points of the diagnostic procedure in systemic autoimmune rheumatic diseases, and make recommendations for the most efficient approach to autoantibody testing, based on selected publications and the relevant literature. Appropriateness is a complex task that can be achieved only by combining the efforts from the laboratory and the clinic, thereby using scientific knowledge, inter-disciplinary consultation and expert clinical investigation.

Key words
Appropriateness, anti-nuclear antibodies, autoantibody tests, guidelines, rheumatic diseases. 

Please address correspondence and reprint requests to: Nicola Bizzaro, MD, Laboratory of Clinical Pathology, Ospedale Civile, 30027 San Doná di Piave (VE), Italy. 
E-mail: nbizzaro@dacos.it

Clin Exp Rheumatol 2004; 22: 349-355.
© Copyright Clinical and Experimental Rheumatology 2004.