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IV Brazilian Guidelines for autoantibodies on HEp-2 cells

Paulo Luiz Carvalho Francescantonio Cruvinel Wilson de Melo Alessandra Dellavance Luis Eduardo Coelho Andrade Ben HurTaliberti Carlos Alberto von Mühlen Carlos David Araújo Bichara Cleonice Bueno Cristóvão Luis Pitangueira Mangueira Darlene Gonçalves Carvalho Eloísa S.D. de O. Bonfá Fabiano de Almeida Brito Flávia Ikeda e Araújo Jozelia Rêgo Kaline Medeiros Costa Pereira Lisiane Maria Enriconi dos Anjos Maria de Fatima Bissoli Mittermayer Barreto Santiago Natalya Zaidan Maluf Rossana Rassi Alvarenga Suzane Pretti Figueiredo Neves Valeria Valim Wilton Silva dos Santos About the authors


The Fourth Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells (ANA) was held in Vitória, Espírito Santo, and aimed to discuss strategies and recommendations about the technique, standardization, interpretation and quality control of the indirect immunofluorescence reaction on HEp-2 cells.


Twenty three ANA experts from university centers and private laboratories in different areas from Brazil discussed and agreed upon recommendations for the fourth edition of the Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells.

Results and conclusion:

The 4th ANA Consensus included three novel patterns into the existing algorithm (cytoplasmic Rods and Rings, nuclear Quasi-homogeneous, and CENP-F). Emphasis was given to the need of attention in describing the peculiar mixed pattern elicited by anti-DNA topoisomerase I (Scl-70) autoantibodies, comprising nuclear fine specked, nucleolar homogeneous pattern, NOR staining in metaphase plates, and cytoplasmic fine speckled patterns. The group also emphasized the need for continuous quality control in indirect immunofluorescence assays, the establishment of screening dilutions, as well as conjugate titration. An alert was made regarding the heterogeneity of commercial kits in defining patterns and the use of solid phase methodologies to determine the presence of autoantibodies.

Autoantibodies; HEp-2 cells; Antinuclear antibodies; Indirect immunofluorescence; ANA consensus

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