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Cruvinel WDM, Andrade LEC, Dellavance A, Ximenes AC, Bichara CDA, Mangueira CLP, Bonfá E, de Almeida Brito F, Mariz HA, Dos Anjos LME, Pasoto SG, Valim V, Dos Santos WFS, Gomes CM, Neves RA, Francescantonio PLC. VI Brazilian consensus guidelines for detection of anti-cell autoantibodies on HEp-2 cells. Adv Rheumatol 2022; 62:34. [PMID: 36071498 DOI: 10.1186/s42358-022-00266-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/24/2022] [Indexed: 01/29/2023] Open
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.
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Affiliation(s)
- Wilson de Melo Cruvinel
- School of Medical and Life Sciences, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC GOIÁS), Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, 74605-010, Brazil.
| | - Luis Eduardo Coelho Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Alessandra Dellavance
- Immunology Division, Fleury Medicine and Health Laboratories, São Paulo, Brazil.,Divisão de Pesquisa, Inovação e Desenvolvimento, Fleury Medicina E Saúde, São Paulo, SP, Brazil
| | | | - Carlos David Araújo Bichara
- Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Amaral Costa Medicina Diagnóstica, Belém, PA, Brazil
| | | | - Eloísa Bonfá
- Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | - Fabiano de Almeida Brito
- Department of Clinical Pathology, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.,Hermes Pardini Group, Vespasiano, MG, Brazil
| | - Henrique Ataíde Mariz
- Rheumatology Department, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | | | - Sandra Gofinet Pasoto
- Serviço de Reumatologia e Laboratório de Autoimunidade da Divisão de Laboratório Central do Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Valeria Valim
- Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | | | - Clayson Moura Gomes
- School of Medical and Life Sciences, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC GOIÁS), Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, 74605-010, Brazil
| | - Roberpaulo Anacleto Neves
- School of Medical and Life Sciences, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC GOIÁS), Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, 74605-010, Brazil
| | - Paulo Luiz Carvalho Francescantonio
- School of Medical and Life Sciences, Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás (PUC GOIÁS), Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, 74605-010, Brazil
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Maluf CB, Brito FDA, Simões TC, Peixoto SV, Vidigal PG. Laboratory profile after mining dam breach: Brumadinho Health Project results. Rev bras epidemiol 2022; 25:e220013. [DOI: 10.1590/1980-549720220013.supl.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/05/2022] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Objective: To evaluate changes in selected laboratory tests in the population included in the Brumadinho Health Project, according to the exposure to the dam failure. Methods: Cross-sectional study carried out on representative sample of residents (≥12 years) in Brumadinho, Minas Gerais, including: 1) non-exposed; 2) directly affected by tailings sludge; 3) residents in mining area. The prevalence of abnormal results of blood count, total, HDL and LDL cholesterol, triglycerides, aspartate aminotransferase, alanine aminotransferase, creatinine, urea, estimate of glomerular filtration rate (eGFR) and high-sensitivity C-reactive protein (hs-CRP) were estimated. The Prevalence Ratios (PR) and 95% Confidence Intervals (95%CI) of having an abnormal laboratory finding were estimated using Generalized Linear Models with Poisson probability distribution. Crude and adjusted models were estimated for age range, gender, diabetes, body mass index, smoking, hypertension. Results: After adjusting, there was no difference in PR between the three populations for most tests, with the exception of the population residing in an area with mining activity and not directly affected by the mud, with a lower chance of having altered total cholesterol (PR: 0.84; 95%CI 0.74–0.95) and a higher chance of having altered HDL cholesterol (PR: 1.26; 95%CI 1.07–1.50), hs-CRP (PR: 1.19; 95%CI 1.04–1.37), and eGFR <60mL/min/1,73 m2 (PR: 1.51; 95%CI 1.05–2.19). Conclusion: No significant differences were found in the prevalence of biochemical and hematological alterations between the populations directly exposed and not exposed to tailings. Only the group residing in the mining area had a higher prevalence of alterations related dyslipidemia, renal disease, and inflammation.
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Maluf CB, Brito FDA, Simões TC, Peixoto SV, Vidigal PG. Perfil laboratorial após rompimento de barragem de mineração: resultados do Projeto Saúde Brumadinho. Rev bras epidemiol 2022. [DOI: 10.1590/1980-549720220013.supl.2.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivo: Avaliar alterações em parâmetros laboratoriais na população do Projeto Saúde Brumadinho, segundo exposição ao rompimento da barragem. Métodos: Estudo transversal realizado em amostra representativa de residentes (≥12 anos) em Brumadinho, Minas Gerais, incluindo: não expostos (grupo referência); diretamente atingidos pela lama de rejeitos; e residentes em área de mineração. Foram estimadas as prevalências de resultados alterados de hemograma, colesterol total, colesterol lipoproteína de alta densidade (HDL), colesterol lipoproteína de baixa densidade (LDL), triglicérides, aspartato aminotransferase, alanina aminotransferase, creatinina, ureia, estimativa da taxa de filtração glomerular (TFGe) e proteína C-reativa ultrassensível (PCRus). As razões de prevalência (RP) e os intervalos de confiança de 95% (IC95%) de ter o exame alterado foram estimados por meio de modelos lineares generalizados com distribuição de probabilidade Poisson. Estimaram-se modelos brutos e ajustados por faixa etária, sexo, diabetes, índice de massa corporal, tabagismo, hipertensão. Resultados: Após ajustes, não se observou diferença nas RP entre as populações estudadas para a maioria dos testes, com exceção da população residente em área com atividade de mineração e não diretamente atingida pela lama, com menor chance de ter colesterol total alterado (RP=0,84; IC95% 0,74–0,95) e maior chance de ter colesterol HDL (RP=1,26; IC95% 1,07–1,50) e PCRus (RP=1,19; IC95% 1,04–1,37) alterado e TFGe<60 mL/min/1,73 m2 (RP=1,51; IC95% 1,05–2,19). Conclusão: Não foram encontradas diferenças significativas na prevalência de alterações bioquímicas e hematológicas entre a população diretamente exposta aos rejeitos e a população não exposta. Apenas o grupo residente em área de mineração apresentou maior prevalência de alterações relacionadas com dislipidemia, disfunção renal e inflamação.
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de Melo Cruvinel W, Andrade LEC, von Mühlen CA, Dellavance A, Ximenes AC, Bichara CD, Bueno C, Mangueira CLP, Bonfá E, de Almeida Brito F, Flumian FB, da Silva GG, Rêgo J, Dos Anjos LME, Slhessarenko N, Pasoto SG, Neves SPF, Valim V, Dos Santos WS, Francescantonio PLC. Correction to: V Brazilian consensus guidelines for detection of anti-cell autoantibodies on hep-2 cells. Adv Rheumatol 2020; 60:6. [PMID: 31907077 DOI: 10.1186/s42358-019-0103-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
After publication of the original article [1], we were notified that there is a mistake in Fig. 2.
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Affiliation(s)
- Wilson de Melo Cruvinel
- Pontifícia Universidade Católica de Goiás (PUC Goiás), Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, CEP 74605-010, Brazil.
| | - Luis Eduardo Coelho Andrade
- Disciplina de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Divisão de Imunologia, Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | - Alessandra Dellavance
- Divisão de Pesquisa, Inovação e Desenvolvimento, Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | - Carlos David Bichara
- Faculdade de Medicina Famaz, Amaral Costa Medicina Diagnóstica, Belém, PA, Brazil
| | - Cleonice Bueno
- Laboratórios de Investigação Médica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FM-USP), São Paulo, SP, Brazil
| | | | - Eloísa Bonfá
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | | | - Jozelia Rêgo
- Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
| | | | - Natasha Slhessarenko
- Universidade Federal de Mato Grosso (UFMT) e Grupo DASA Cuiabá, Cuiabá, MT, Brazil
| | - Sandra Gofinet Pasoto
- Serviço de Reumatologia e Laboratório de Autoimunidade da Divisão de Laboratório Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Suzane Pretti Figueiredo Neves
- Departamento de Propedêutica Complementar da Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Valéria Valim
- Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Wilton Silva Dos Santos
- Escola Superior de Ciências da Saúde do Distrito Federal e Laboratório Sabin, Brasília, DF, Brazil
| | - Paulo Luiz Carvalho Francescantonio
- Pontifícia Universidade Católica de Goiás (PUC Goiás), Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, CEP 74605-010, Brazil.
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Cruvinel WDM, Andrade LEC, von Mühlen CA, Dellavance A, Ximenes AC, Bichara CD, Bueno C, Mangueira CLP, Bonfá E, de Almeida Brito F, Flumian FB, da Silva GG, Rêgo J, Dos Anjos LME, Slhessarenko N, Pasoto SG, Neves SPF, Valim V, Dos Santos WS, Francescantonio PLC. V Brazilian consensus guidelines for detection of anti-cell autoantibodies on hep-2 cells. Adv Rheumatol 2019; 59:28. [PMID: 31269997 DOI: 10.1186/s42358-019-0069-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The V Brazilian Consensus for determination of autoantibodies against cellular constituents on HEp-2 cells, held in Brasilia (DF, Brazil) on August 27, 2016, discussed the harmonization between the Brazilian Consensus on ANA (BCA) guidelines and the International Consensus on ANA Patterns (ICAP) recommendations ( www.anapatterns.org ). Initial guidelines were formulated by the group of Brazilian experts with the purpose of guiding and enabling Brazilian clinical laboratories to adopt recommendations and to provide a common standard for national and international consensuses. MAINBODY Twenty Brazilian researchers and experts from universities and clinical laboratories representing the various geographical regions of the country participated in the meeting. Three main topics were discussed, namely the harmonization between the BCA guidelines and latest recommendations of the ICAP initiative, the adjustment of the terminology and report on HEp-2 patterns, and a reassessment of quality assurance parameters. For the three topics, our aim was to establish specific guidelines. All recommendations were based on consensus among participants. There was concrete progress in the adjustment of the BCA guidelines to match the ICAP guidelines. To a certain extent, this derives from the fact that ICAP recommendations were largely based on the algorithm and recommendations of the IV Brazilian ANA Consensus, as consistently recognized in the ICAP publications and presentations. However, although there is great overlap between the two Consensuses, there are some point divergences. These specific items were individually and extensively discussed, and it was acknowledged that in several points ICAP improved recommendations previously issued by the Brazilian ANA Consensus and these changes were readily implemented. Regarding some specific topics, the BCA panel of experts felt that the previously issued recommendations remained relevant and possibly will require further discussion with ICAP. The term anti-cell antibodies was adopted as the recommended designation, recognizing that the assay addresses antibodies against antigens in the nucleus and in other cell compartments. However, the acronym ANA HEp-2 was maintained due to historical and regulatory reasons. It was also signalized that the latest trend in ICAP is to adopt the term Indirect Immunofluorescent Assay on HEp-2 cell substrate (HEp-2 IIFA). In addition, the quality assurance strategies previously presented were ratified and emphasized. CONCLUSION The V BCA edition was successful in establishing an overall harmonization with the ICAP recommendations for interpretation of the HEp-2 IIFA test, pinpointing the perspectives in filling the remaining gaps between both initiatives.
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Affiliation(s)
- Wilson de Melo Cruvinel
- Pontifícia Universidade Católica de Goiás (PUC Goiás), Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, CEP, 74605-010, Brazil.
| | - Luis Eduardo Coelho Andrade
- Disciplina de Reumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Divisão de Imunologia, Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | - Alessandra Dellavance
- Divisão de Pesquisa, Inovação e Desenvolvimento, Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | - Carlos David Bichara
- Faculdade de Medicina Famaz, Amaral Costa Medicina Diagnóstica, Belém, PA, Brazil
| | - Cleonice Bueno
- Laboratórios de Investigação Médica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FM-USP), São Paulo, SP, Brazil
| | | | - Eloísa Bonfá
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | | | - Jozelia Rêgo
- Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
| | | | - Natasha Slhessarenko
- Universidade Federal de Mato Grosso (UFMT) e Grupo DASA Cuiabá, Cuiabá, MT, Brazil
| | - Sandra Gofinet Pasoto
- Serviço de Reumatologia e Laboratório de Autoimunidade da Divisão de Laboratório Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Suzane Pretti Figueiredo Neves
- Departamento de Propedêutica Complementar da Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Valéria Valim
- Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Wilton Silva Dos Santos
- Escola Superior de Ciências da Saúde do Distrito Federal e Laboratório Sabin, Brasília, DF, Brazil
| | - Paulo Luiz Carvalho Francescantonio
- Pontifícia Universidade Católica de Goiás (PUC Goiás), Escola de Ciências Médicas, Farmacêuticas e Biomédicas, Avenida Universitária 1.440, Setor Universitário, Goiânia, GO, CEP, 74605-010, Brazil.
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de Almeida Brito F, Maria Elói Santos S, Aparecida Ferreira G, Pedrosa W, Gradisse J, Cristina Costa L, Pretti Figueiredo Neves S. Diagnostic Evaluation of ELISA and Chemiluminescent Assays as Alternative Screening Tests to Indirect Immunofluorescence for the Detection of Antibodies to Cellular Antigens. Am J Clin Pathol 2016; 145:323-31. [PMID: 27124914 DOI: 10.1093/ajcp/aqv083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Detection of antinuclear antibodies (ANAs) plays an important role in the diagnosis of systemic autoimmune rheumatic disease (SARD). Our goal was to evaluate the diagnostic accuracy of three commercially available enzyme-linked immunosorbent assay (ELISA) kits and one chemiluminescent assay for ANA detection, using the clinical diagnostic as the reference standard. METHODS We evaluated serum samples from 143 patients with an established diagnosis of SARD (group 1), 166 patients with infectious diseases and other rheumatic diseases for which the ANA test is not useful in diagnosis (group 2), and 89 outpatients with suspicion of SARD (group 3). RESULTS The sensitivity for ANA HEp-2, calculated in group 1, was 87.4% and varied between 62.9% and 90.0% for other tests. The specificity for ANA HEp-2, calculated in group 2, was 72.3% and varied between 45.2% and 90.4% for other tests. In group 3, the negative predictive value for ANA Hep-2 was 92.5% and varied between 89.3% and 100% for other tests. CONCLUSIONS Some ELISA kits have comparable or superior diagnostic sensitivity to ANA HEp-2 and could be used as an alternative method for ANA screening, therefore allowing the immediate report of the results with fewer false negatives than ANA HEp-2. Owing to the lower specificity, ELISA-positive samples should be submitted to ANA HEp-2 for confirmation of results.
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Affiliation(s)
- Fabiano de Almeida Brito
- From the Hermes Pardini, Belo Horizonte, Minas Gerais, Brazil; and Departamento de Propedêutica Complementar
| | | | - Gilda Aparecida Ferreira
- Departamento do Aparelho Locomotor, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - William Pedrosa
- From the Hermes Pardini, Belo Horizonte, Minas Gerais, Brazil; and
| | - Janaina Gradisse
- From the Hermes Pardini, Belo Horizonte, Minas Gerais, Brazil; and
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Francescantonio PLC, Cruvinel WDM, Dellavance A, Andrade LEC, HurTaliberti B, Mühlen CAV, Bichara CDA, Bueno C, Mangueira CLP, Carvalho DG, Bonfá ESDO, Brito FDA, Araújo FIE, Rêgo J, Pereira KMC, Anjos LMED, Bissoli MDF, Santiago MB, Maluf NZ, Alvarenga RR, Neves SPF, Valim V, Santos WSD. IV Brazilian Guidelines for autoantibodies on HEp-2 cells. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.rbre.2014.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Francescantonio PLC, Cruvinel WDM, Dellavance A, Andrade LEC, HurTaliberti B, Mühlen CAV, Bichara CDA, Bueno C, Mangueira CLP, Carvalho DG, Bonfá ESDO, Brito FDA, Araújo FIE, Rêgo J, Pereira KMC, Anjos LMED, Bissoli MDF, Santiago MB, Maluf NZ, Alvarenga RR, Neves SPF, Valim V, Santos WSD. IV Consenso Brasileiro para pesquisa de autoanticorpos em células HEp-2. Revista Brasileira de Reumatologia 2014. [DOI: 10.1016/j.rbr.2013.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Francescantonio PLC, Cruvinel WDM, Dellavance A, Andrade LEC, Taliberti BH, von Mühlen CA, Bichara CDA, Bueno C, Mangueira CLP, Carvalho DG, Bonfá ESDDO, Brito FDA, Araújo FIE, Rêgo J, Pereira KMC, dos Anjos LME, Bissoli MDF, Santiago MB, Maluf NZ, Alvarenga RR, Neves SPF, Valim V, dos Santos WS. IV Brazilian guidelines for autoantibodies on HEp-2 cells. Rev Bras Reumatol 2014; 54:44-50. [PMID: 24878791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 10/13/2013] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE The Fourth Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells (ANA) was held in Vitória, Espírito Santo, and aimed to discuss strategies and recommendations about the technique, standardization, interpretation and quality control of the indirect immunofluorescence reaction on HEp-2 cells. METHODS Twenty three ANA experts from university centers and private laboratories in different areas from Brazil discussed and agreed upon recommendations for the fourth edition of the Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells. RESULTS AND CONCLUSION The 4th ANA Consensus included three novel patterns into the existing algorithm (cytoplasmic Rods and Rings, nuclear Quasi-homogeneous, and CENP-F). Emphasis was given to the need of attention in describing the peculiar mixed pattern elicited by anti-DNA topoisomerase I (Scl-70) autoantibodies, comprising nuclear fine specked, nucleolar homogeneous pattern, NOR staining in metaphase plates, and cytoplasmic fine speckled patterns. The group also emphasized the need for continuous quality control in indirect immunofluorescence assays, the establishment of screening dilutions, as well as conjugate titration. An alert was made regarding the heterogeneity of commercial kits in defining patterns and the use of solid phase methodologies to determine the presence of autoantibodies.
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Affiliation(s)
| | | | | | | | - Ben Hur Taliberti
- Serviço de Reumatologia, Hospital das Clínicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil
| | - Carlos Alberto von Mühlen
- Centro de Diagnósticos Médicos e Rheuma Clínica de Doenças Reumáticas de Porto Alegre, Porto Alegre, RS, Brasil
| | | | - Cleonice Bueno
- Laboratórios de Investigação Médica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | | | | | | | | | - Jozelia Rêgo
- Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brasil
| | | | | | | | | | | | | | | | - Valeria Valim
- Universidade Federal do Espírito Santo, Vitória, ES, Brasil
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Brito FDA, Santos SME, Ferreira GA, Pedrosa W, Gradisse J, Costa LC, Neves SPF. Detection of anti-nuclear antibodies by indirect immunofluorescence on HEp-2 cells: setting the appropriate screening dilution for the diagnosis of autoimmune rheumatic diseases. Rev Bras Reumatol 2014; 54:13-20. [PMID: 24878786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 06/02/2013] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To establish the abnormal title and the appropriate screening dilution for ANA (antinuclear antibodies) test by indirect immunofluorescence on HEp-2 cells (ANA HEp-2). METHODS An analysis of ANA Hep-2 in serum samples from 126 healthy individuals was performed. The samples were screened at a dilution of 1:80, and those positive were diluted to the title of 1:5120. The abnormal title of ANA was defined as that corresponding to the 95th percentile of the test in this population. The sensitivity of the different titles of antinuclear antibodies was determined in a group of 136 patients with a diagnosis of autoimmune rheumatic disease, and the specificity was determined in a group of 118 patients with other rheumatic diseases. The optimal cutoff value of the test was determined by ROC curve analysis. RESULTS The frequency of ANA positivity in healthy subjects was 13.2%. There was no difference in the frequency of positive results according to gender or age. The abnormal title of ANA was defined as the dilution of 1:160. The 1:80 dilution had sensitivity of 87.7% and specificity of 67.8%, while the 1:160 dilution had sensitivity of 82% and specificity of 73.7%. By ROC curve analysis, a dilution of 1:160 corresponded to the optimal cutoff value. CONCLUSION The abnormal title and the optimal cutoff value of ANA HEp-2 in the population was 1:160. Therefore, the dilution of 1:160 is the optimal screening dilution, with better specificity but without significantly compromising the sensitivity of the diagnostic test.
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Affiliation(s)
| | - Silvana Maria Elói Santos
- Departamento de Propedêutica Complementar, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Gilda Aparecida Ferreira
- Departamento do Aparelho Locomotor, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - William Pedrosa
- Instituto Hermes Pardini, Belo Horizonte, Belo Horizonte, MG, Brasil
| | - Janaina Gradisse
- Instituto Hermes Pardini, Belo Horizonte, Belo Horizonte, MG, Brasil
| | | | - Suzane Pretti Figueiredo Neves
- Departamento de Propedêutica Complementar, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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