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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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