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.

Nov 16, 2018

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.

Type of practice

Laboratory tests

Age

Adult, Geriatric, Pediatric

Topic Area

Laboratory Medicine

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 autoimmune myositis, the first-line serological test to be performed should be a multispecific immunometric test for the full spectrum of MSA/MAA antibodies.

Sources

1. Damoiseaux J, Vulsteke JB, Tseng CW, et al. Autoantibodies in idiopathic inflammatory myopathies: Clinical associations and laboratory evaluation by mono- and multispecific immunoassays. Autoimmun Rev 2019; 18:293-305. doi: 10.1016/j.autrev.2018.10.004.
2. Palterer B, Vitiello G, Carraresi A, et al. Bench to bedside review of myositis autoantibodies. Clin Mol Allergy 2018; 16:5 https://doi.org/10.1186/s12948-018-0084-9.
3. Damoiseaux J, Mammen AL, Piette Y, et al; ENMC 256th Workshop Study Group. 256th ENMC international workshop: Myositis specific and associated autoantibodies (MSA-ab): Amsterdam, The Netherlands, 8-10 October 2021. Neuromuscul Disord 2022; 32:594-608. doi: 10.1016/j.nmd.2022.05.011.

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.