Ann Rheum Dis 69:1420-1422 doi:10.1136/ard.2009.127100
  • Viewpoint

ANA screening: an old test with new recommendations

  1. Peter H Schur2
  1. 1Division of Rheumatology, Department of Internal Medicine, Istituto G Pini, University of Milan and IRCCS Istituto Auxologico Italiano, Milan, Italy
  2. 2Division of Rheumatology, Harvard Medical School, Brigham and Women's Hospital, Boston, USA
  1. Correspondence to Pier Luigi Meroni, Division of Rheumatology, Department of Internal Medicine, Istituto G Pini, Pzza A Ferrari, 1, Milan 20122, Italy; pierluigi.meroni{at}
  1. Contributors Both authors contributed to the conception and design, acquisition of data or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version published.

  • Accepted 21 March 2010
  • Published Online First 28 May 2010


The impact of autoimmune diseases is growing from both a clinical and a laboratory point of view. Diagnostic assays are now being transferred from dedicated specialised laboratories into high-throughput service laboratories. The increasing number of available methods has raised the variability among the laboratories, making their reproducibility a critical problem. On the other hand, reliable tests are needed for early diagnosis and prompt treatment, and the cost of repeated confirmatory tests should be reduced and unnecessary further investigations avoided. New methodologies, particularly for antinuclear antibodies (ANAs), have been applied to autoantibody detection in order to screen and process larger volumes of clinical specimens more quickly and at less cost than the traditional methods. However, because of the lack of their sensitivity to detect all ANAs and standardisation, inaccuracies (including false positives and negatives) in the results have been reported. A committee of the American College of Rheumatology was formed to address this issue. Specific recommendations have been suggested that represent a realistic first step in the standardisation of diagnostic tests for autoimmune diseases.


  • Competing interests None.

  • Funding This paper was supported by Minister of Health, Italy, Ricerca Corrente IRCCS Istituto Auxologico Italiano to PLM.

  • Provenance and peer review Not commissioned; externally peer reviewed.