When myasthenia gravis is suspected, specific autoantibodies (AChR, MuSK, Lrp4) should not be searched as a profile, but the initial test is represented only by anti-AchR antibodies.
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...
Do not order the HEp-2 indirect immunofluorescence test for ANA (antibodies to cellular antigens) as a screening test in patients with suspected autoimmune myositis.
The use of ANA IIF as the sole screening method for MSA/MAA (Myositis-Specific Ab/Myositis-Associated Ab) is not recommended due to low sensitivity, very low specificity and/or lack of antigen expression by HEp-2 cells. Therefore, in case of clinical suspicion of...
In the case of autoimmune thyrotoxicosis / hyperthyroidism, anti-TPO and anti-Tg antibodies should not be sought; search instead for anti-TSHR antibodies (TRAb). Do not request anti-TPO (anti-thyroid peroxidase) and anti-Tg (anti-thyroglobulin) antibody tests in the monitoring of autoimmune thyroid disease.
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. The research of anti-TPO is useful only in case of negativity of TRAb (possible...
Do not diagnose Urinary Tract Infection based on urine cultures alone
Urine culture has to be performed after having a urine sample checked for the presence of leucocytes and/or nitrites, with dipstick, or by microscopic urinalysis, and in some special cases, together with urinoculture. In the absence of a pathologic multistick test or...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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