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European Attempts to Set Guidelines for Improving Diagnostics of Autoimmune Rheumatic Disorders

Department of Autoimmunology, Statens Serum Institut, Copenhagen, Denmark, aw{at}ssi.dk

R Cervera

Unit of Autoimmune Diseases, Hospital Clinic I, Barcelona, Spain

M Haass

Pharmacia Diagnostics, Diagnostics Division, Freiburg, Germany

M Khamashta

Lupus Arthritis Research Unit, Rayne Institute, St Thomas’ Hospital, London, UK

PL Meroni

Department of Internal Medicine, Istituto Auxiologico, University of Milan, Italy

J-C Piette

Department of Internal Medicine, Hopital Pitie-Salpetrière, Paris, France

R Schmitt

Department of Clinical Immunlogy, Medical School, University of Hannover, Germany

Y Shoenfeld

Department of Medicine B, Sheba Medical Center I, Tel Aviv, Israel

The rational way to set a diagnosis and estimate a prognosis in rheumatology is to start by setting a tentative diagnosis and then follow a fixed scheme for laboratory testing, eg, by using an agreed algorithm. The use of order algorithms can be extended to post-test algorithms that will assist clinicians in approaching the right diagnosis and prognosis. New methods used in autoimmune serology do not deliver results that can be directly compared to those of older methods, and thus the new methods need to be thoroughly tested with sera from differential diagnostically relevant disease controls to set a clinically meaningful cut-off for positivity. Borderline positive results need to be treated with special care to avoid misuse. Early diagnosis is of great importance, and serological results can be very useful if used the right way. European efforts to secure rational diagnostic work-up in autoimmune rheumatic disease have led to a better dialogue between clinicians and laboratory scientists in several countries.

Key Words: autoantibodies • clinical use • early diagnosis • guidelines • methods • reporting

Lupus, Vol. 15, No. 7, 391-396 (2006)
DOI: 10.1191/0961203306lu2322oa


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