Konstantinov Konstantin N, Rubin Robert L
Division of Rheumatology/Department of Internal Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, Mail Stop MSC10-5550, Albuquerque, NM, 87131, USA.
Rheumatology Section, Raymond G. Murphy VA Medical Center, 1501 San Pedro SE, Albuquerque, NM, 87108, USA.
Auto Immun Highlights. 2017 Dec;8(1):4. doi: 10.1007/s13317-017-0093-6. Epub 2017 Mar 21.
Testing for total antinuclear antibodies (ANA) is a critical tool for diagnosis and management of autoimmune diseases at both the primary care and subspecialty settings. Repurposing of ANA from a test for lupus to a test for any autoimmune condition has driven the increase in ANA requests. Changes in ANA referral patterns include early or subclinical autoimmune disease detection in patients with low pre-test probability and use of negative ANA results to rule out underlying autoimmune disease. A positive result can lead to further diagnostic considerations. Currently, ANA tests are performed in centralized laboratories; an alternative would be ANA testing at the clinical point-of-care (POC). By virtue of its near real-time data collection capability, low cost, and ease of use, we believe the POC ANA has the potential to enable a new paradigm shift in autoimmune serology testing.
检测抗核抗体(ANA)总量是基层医疗和专科医疗环境中诊断和管理自身免疫性疾病的关键工具。将ANA检测从用于狼疮的检测重新定位为用于任何自身免疫性疾病的检测,推动了ANA检测需求的增加。ANA转诊模式的变化包括在检测前概率较低的患者中早期或亚临床自身免疫性疾病的检测,以及使用ANA阴性结果排除潜在的自身免疫性疾病。阳性结果可能会导致进一步的诊断考量。目前,ANA检测在集中实验室进行;另一种选择是在临床护理点(POC)进行ANA检测。凭借其近乎实时的数据收集能力、低成本和易用性,我们认为POC ANA有潜力在自身免疫性血清学检测中实现新的范式转变。