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Response to: ’Unending story of the indirect immunofluorescence assay on HEp-2 cells: old problems and new solutions?' by Meroni et al
  1. David S Pisetsky1,
  2. Diane M Spencer1,
  3. Peter E Lipsky2,
  4. Brad H Rovin3
  1. 1 Department of Medicine and Immunology, Duke University Medical Center and Medical Research Service, VA Medical Center, Durham, North Carolina, USA
  2. 2 RILITE Research Institute, Charlottesville, Virginia, USA
  3. 3 Division of Nephrology, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
  1. Correspondence to Dr David S Pisetsky, Department of Medicine and Immunology, Duke University Medical Center, Durham, NC 27705, USA; david.pisetsky{at}

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We would like to thank Professor Meroni and colleagues for their comments1 regarding our paper2 on testing for antinuclear antibodies (ANAs) in patients with systemic lupus erythematosus (SLE) and the very thoughtful discussion of the approaches for serological determinations. This letter provides a further perspective on ANA assays that were also discussed in a letter to this journal by Dr M Mahler.3 With respect to approaches to serological testing beyond immunofluorescence assays (IFA), we fully agree that solid phase assays (SPA) can provide a useful adjunctive approach and, indeed, we provided data on an ANA ELISA in our paper. In our study, the SPA kit that we assessed did not perform better than the IFA tests (11.7% ANA negative for the …

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