Linee guida per l’utilizzo dei test autoanticorpali nella diagnosi e nel monitoraggio delle malattie autoimmuni reumatiche sistemiche. Revisione 2015

  • Luigi Cinquanta
  • Nicola Bizzaro
  • Danilo Villalta
  • Gabriella Morozzi
  • Elio Tonutti
  • Marcello Bagnasco
  • Giampaola Pesce
  • Danila Bassetti
  • Brunetta Porcelli
  • Lucia Terzuoli
  • Antonio Antico
  • Antonella Radice
  • Gaia Deleonardi
  • Marilina Tampoia
  • Renato Tozzoli
Rassegna

Riassunto

Il Gruppo di Studio in Autoimmunologia (GdS-AI) della Società Italiana di Patologia Clinica e Medicina di Laboratorio (SIPMeL), dopo 14 anni dalla ultima edizione, ha ritenuto opportuno revisionare e integrare le “linee guida per l’impiego di test per autoanticorpi nucleo-citoplasmatici nella diagnosi e nel monitoraggio delle malattie autoimmuni sistemiche”, con l’aggiunta di nuove tematiche, la modifica di precedenti raccomandazioni e la rivalutazione di aspetti controversi del precedente documento.

Per l’elaborazione di questa edizione, la valutazione della “qualità delle evidenze” e l’espressione della “forza delle raccomandazioni” sono state definite secondo il metodo GRADE (Grading of Recommendation Assessment, Development and Evaluation), frutto dell’attività avviata nel 2000 da un gruppo di lavoro internazionale che aveva come scopo la definizione di un metodo rigoroso ed esplicito per la produzione di raccomandazioni cliniche. Il documento è articolato in 18 raccomandazioni, suddivise in 4 sezioni; ognuna di esse è introdotta da un quesito clinico con scelta e valutazione formale degli outcome a esso correlati, seguito dalla valutazione sistematica della letteratura scientifica e della qualità delle prove reperite. La definizione formale della forza delle raccomandazioni, espressa come “forte” o “debole”, è stata assegnata per consenso da tutti i membri del GdS-AI della SIPMeL. Questa revisione delle linee guida, nel fornire una sintesi sullo stato attuale dei test per la ricerca degli autoanticorpi anti-antigeni intracellulari, formula una serie di raccomandazioni rivolte soprattutto all’appropriatezza della richiesta, alla metodologia analitica da utilizzare, all’interpretazione e alla modalità di refertazione dei risultati. Infine, il documento affronta problematiche ancora aperte, quali l’utilizzo di nuovi termini e acronimi per denominare i test autoanticorpali in uso nella diagnostica delle malattie reumatiche autoimmuni e la standardizzazione dei metodi di dosaggio degli autoanticorpi.

Parole chiave

Linee guida Malattie reumatiche autoimmuni GRADE Raccomandazione Autoanticorpi 

Guidelines for the laboratory use of autoantibody tests in the diagnosis and monitoring of autoimmune rheumatic diseases. Revision 2015

Summary

After 14 years since the last edition, the Study Group on Autoimmune Diseases (GdS-AI) of the Italian Society of Clinical Pathology and Laboratory Medicine (SIPMeL) has revised and supplemented the “Guidelines for the laboratory use of autoantibody tests in the diagnosis and monitoring of autoimmune rheumatic diseases”, with addition of new themes, update of recommendations and revaluation of the controversial aspects of the previous document. For the preparation of this edition, the assessment of the “quality of evidence” and of “strength of the recommendations” has been defined by the GRADE (Grading of Recommendation Assessment, Development and Evaluation) method, developed in 2000 by an international working group as a rigorous and explicit method for the production of clinical recommendations. The document is divided into 4 sections including 18 recommendations; each is introduced by a question, followed by the systematic evaluation of the scientific literature and the quality of the evidence found. The formal definition of the strength of the recommendations, expressed as “strong” or “weak”, has been assigned by consensus of all members of GdS-AI SIPMeL. This updated revision of the guidelines provides an overview on the current status of the tests for the detection of autoantibodies to intracellular antigens, including solid phase immunoassays and the automated reading of indirect immunofluorescence. Recommendations are directed mainly to the appropriateness of the request, the analytical methodology to be used, the interpretation and reporting of results. Finally, the document approaches open issues, such as the use of new terms and acronyms to name autoantibody tests used to diagnose autoimmune rheumatic diseases and the harmonization of procedures for the detection of autoantibodies.

Keywords

Guidelines Autoimmune rheumatic diseases GRADE Recommendation Autoantibodies 

Notes

Conflitti di interesse

Nessuno.

Studi condotti su esseri umani e animali

Per questo tipo di studio non è richiesto l’inserimento di alcuna dichiarazione relativa agli studi effettuati su esseri umani e animali.

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Copyright information

© Springer-Verlag Italia 2015

Authors and Affiliations

  • Luigi Cinquanta
    • 1
  • Nicola Bizzaro
    • 2
  • Danilo Villalta
    • 3
  • Gabriella Morozzi
    • 4
  • Elio Tonutti
    • 5
  • Marcello Bagnasco
    • 6
  • Giampaola Pesce
    • 6
  • Danila Bassetti
    • 7
  • Brunetta Porcelli
    • 8
  • Lucia Terzuoli
    • 8
  • Antonio Antico
    • 9
  • Antonella Radice
    • 10
  • Gaia Deleonardi
    • 11
  • Marilina Tampoia
    • 12
  • Renato Tozzoli
    • 13
  1. 1.Laboratorio di Patologia ClinicaAzienda Ospedaliera San Giovanni di Dio e Ruggi D’AragonaSalernoItalia
  2. 2.Laboratorio di Patologia ClinicaOspedale San AntonioTolmezzoItalia
  3. 3.Allergologia e Immunologia ClinicaPresidio Ospedaliero S. Maria degli AngeliPordenoneItalia
  4. 4.Dipartimento di Scienze Mediche, Chirurgiche e NeuroscienzeAzienda Ospedaliera Universitaria SeneseSienaItalia
  5. 5.Immunopatologia e AllergologiaAzienda Ospedaliera S. Maria della MisericordiaUdineItalia
  6. 6.DIMIUniversità degli Studi di GenovaGenovaItalia
  7. 7.Microbiologia e VirologiaOspedale S. ChiaraTrentoItalia
  8. 8.Dipartimento Biotecnologie MedicheUniversità degli Studi di SienaSienaItalia
  9. 9.Laboratorio AnalisiOspedale CivileSantorsoItalia
  10. 10.UO Microbiologia e VirologiaOspedale San Carlo BorromeoMilanoItalia
  11. 11.Laboratorio AnalisiOspedale MaggioreBolognaItalia
  12. 12.Patologia Clinica UniversitariaPoliclinico ConsorzialeBariItalia
  13. 13.Laboratorio di Patologia ClinicaPresidio Ospedaliero S. Maria degli AngeliPordenoneItalia

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