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Results were interpreted using NOVA View (Inova Diagnostics), an automated digital image analysis system which is used for acquiring, analyzing, and interpreting ANA testing on HEp-2 cells, based on measured light intensity units (LIU) and pattern recognition.
Although this has raised many discussions on the definition and positioning of ANA testing [6, 7, 8], ANA detection by IIF has the advantage of obtaining information on the IIF staining pattern, which is considered of added clinical value.
Specialty society partners American College of Rheumatology [22] and Canadian Rheumatology Association [23] contributed recommendations for appropriate ANA utilization, stressing that duplicative ANA testing is not warranted if there is high pre-test probability for immune-mediated disease and/or active disease.
The clinical value of ANA testing for AARD and autoimmune liver diseases is beyond doubt, but harmonization of reporting ANA test results still needs a few hurdles to take.
Current ANA testing is performed exclusively in centralized clinical laboratories.
First and foremost, ANA testing has a very low predictive value.
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To simplify and standardize the ANA test, generic ANA solid phase enzyme immunoassay has been promoted.
Today, ANA test ordering practice follows one of the following patterns: 1. Intent to diagnose (subspecialists) .
The Indirect Immunofluorescence (IIF) protocol applied on Human Epithelial type 2 (HEp-2) cells is the current gold standard for the Antinuclear Antibody (ANA) test.
This final consideration is of particular importance when we bear in mind how the prescription of the co-called ANA tests has changed over the years.
An additional consideration regards the capacity of a positive ANA test to predict uveitis in juvenile idiopathic arthritis (JIA) or to evidence autoantibodies that correlate with autoimmune hepatitis.
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