SIPMeL

SIPMeL
Italian Society for Clinical Pathology and Laboratory Medicine

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).
Do not request anti-TPO (anti-thyroid peroxidase) and anti-Tg (anti-thyroglobulin) antibody tests in the monitoring of autoimmune thyroid disease.
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.
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.
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.

released: 1 November 2018
last updated: 1 November 2018

PDF

How this list was created

In November 2017, the SIPMeL Study Group in Autoimmunology (GdS-AI) organized a national conference in Santa Margherita Ligure to formulate and discuss some proposals regarding procedures at greater risk of inappropriateness in the field of autoimmune laboratory diagnostics. Of the 19 proposals presented by five working groups and submitted to the evaluation by televoting and discussion in the hall with the participants, five were chosen and approved. In the following months, additional comments and proposals were collected. The National Council has approved them.

 


released: 1 April 2017
last updated: 1 April 2017

PDF

How this list was created

In 2015 at the 1° SIPMeL National Meeting, a working group proposed a tentative top five list of tests with a high risk of inappropriateness. The list was discussed and approved in the specific “Slow Medicine” Session. For some following months other comments and indications were accepted on the Society website; none of other suggestions had better consensus than the first five. In 2016 the National Council approved them.


released: 1 November 2016
last updated: 1 June 2018

PDF

How this list was created

The Endocrinology and Metabolic Diseases (EMM) Study Group of the Italian Society of Clinical Pathology and Laboratory Medicine started in 2008. It includes professionals who work on Endocrinology and Metabolic Diseases in laboratories of different sizes throughout Italy with the aim to study and discuss the theoretical and practical laboratory aspects of Endocrinology and Metabolic Diseases. All the members of the Group sent to the project coordinator up to 5 procedures at risk of inappropriateness and assigned to each procedure a 1-10 score with a brief motivation and the most significant bibliographic references. The coordinator prepared a summary of the submitted proposals, and the overall score of each procedure. The ranking obtained was sent to the Study Group members for final evaluation and the list of the 5 procedures at the highest risk of inappropriateness in EMM was approved.

About this society:

The Italian Society of Clinical Pathology and Laboratory Medicine (SIPMeL) is a national medical/scientific association of professionals working in clinical laboratories. The SIPMeL was established in 2014 after the re-union of SIMeL (Italian Society of Laboratory Medicine), founded in 1986, and AIPaCMeM (Italian Association of Clinical Pathology and Molecular Medicine). The structure of society with 2000 members is federal and includes three professional components: medical doctors, graduates in scientific disciplines (DSLB) and biomedical laboratory technicians (STLB). The aim of the society is to develop and disseminate the professional standards on which the laboratory “good practice” is based. The participants to the education activities of the society receive training credits in accordance with the Ministry of Health’s Continuing Medical Education Program. The scientific research and training activities are promoted and maintained by 22 study groups. www.sipmel.it/it/