The search for anti-insular cell antibodies (ICA) and anti-insulin antibodies (IAA) should not be performed in the case of suspected late-onset autoimmune diabetes (LADA) or gestational diabetes mellitus. Search instead simultaneously for anti-GAD, anti-IA2 and anti-ZnT8 antibodies.

The search for anti-insular cell antibodies (ICA) and anti-insulin antibodies (IAA) should not be performed in the case of suspected late-onset autoimmune diabetes (LADA) or gestational diabetes mellitus. Search instead simultaneously for anti-GAD, anti-IA2 and anti-ZnT8 antibodies.

by | Nov 16, 2018

The finding of even one antibody positivity among anti-GAD, anti-IA2 and anti-ZnT8 is a diagnostic criterion of LADA and suggests an autoimmune pathogenesis in gestational diabetes mellitus.
The search for anti-insular cell antibodies (ICA) and anti-insulin antibodies (IAA) should not be performed in the case of suspected late-onset autoimmune diabetes (LADA) or gestational diabetes mellitus. Search instead simultaneously for anti-GAD, anti-IA2 and anti-ZnT8 antibodies.

Invasive endoscopic investigation with multiple biopsies should not be performed in all patients suspected of autoimmune gastritis but only in those presenting with alteration of serum markers of gastric function (pepsinogen I and II, gastrin 17) and/or antibodies against gastric parietal cells (PCA) and anti-intrinsic factor (IFA). For the determination of PCA and IFA, the use of quantitative immunometric methods is preferable.

by | Nov 16, 2018

In the presence of gastric function compatible with atrophy and autoantibody positivity the suspicion is substantial and it is necessary to proceed to gastric biopsy.
The search for anti-insular cell antibodies (ICA) and anti-insulin antibodies (IAA) should not be performed in the case of suspected late-onset autoimmune diabetes (LADA) or gestational diabetes mellitus. Search instead simultaneously for anti-GAD, anti-IA2 and anti-ZnT8 antibodies.

Specific autoantibodies (AChR, MuSK, Lrp4) should not be required as a profile when myasthenia gravis is suspected, but the initial test is represented only by anti-AchR antibodies. The determination of anti-Musk antibodies should be reserved for anti-AChR negative patients, while that of anti-Lrp4 antibodies should be limited to anti-AChR and anti-MuSK negative patients.

by | Nov 16, 2018

Since the three autoantibodies are mutually exclusive, it is not useful to simultaneously request the determination of all three antibodies, because about 80% of patients with myasthenia have only anti-AChR, 16% only anti-MuSK and the remaining 4% only anti-Lrp4...
The search for anti-insular cell antibodies (ICA) and anti-insulin antibodies (IAA) should not be performed in the case of suspected late-onset autoimmune diabetes (LADA) or gestational diabetes mellitus. Search instead simultaneously for anti-GAD, anti-IA2 and anti-ZnT8 antibodies.

Anti-TPO and anti-Tg antibodies should not be sought in the case of autoimmune thyrotoxicosis / hyperthyroidism; search instead for anti-TSHR antibodies (TRAb). The research of anti-TPO is useful only in case of negativity of TRAb (possible diagnosis of non-Graves thyrotoxicosis).

by | Nov 16, 2018

In the diagnosis of hyperthyroidism, the research of anti-TPO and anti-Tg is widely requested as a first test, while the diagnostic antibody is the one directed towards the TSH receptor.