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How to report the antinuclear antibodies (anti-cell antibodies) test on HEp-2 cells: guidelines from the ICAP initiative

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Abstract

Results of the anti-nuclear antibodies-indirect immunofluorescence assay (anti-cell antibodies test) on HEp-2 cell substrates should be communicated to clinicians in a standardized way, adding value to laboratory findings and helping with critical clinical decisions. This paper proposes a test report based on the practices informed by 118 laboratories in 68 countries, with recommendations from the International Consensus on ANA Patterns (ICAP) group. Major focus is placed on the report format containing endpoint titers, immunofluorescence patterns together with anti-cell (AC) nomenclature, remarks on follow-up or reflex testing, and possible other autoantibody associations. ISO 15,189 directives were integrated into the test report. Special situations addressed include serum screening dilutions and endpoint titers, relevance of immunofluorescence patterns with special attention to cytoplasmic patterns, mixed and compound patterns, and how to report different titers corresponding to multiple patterns or autoantibodies in the same sample. This paper suggests a subtitle for the HEp-2-IIFA, namely anti-cell antibodies test, which could gradually substitute the original outdated ANA nomenclature. This ICAP pro forma report represents a further step in harmonizing the way relevant clinical information could be provided by laboratories.

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References

  1. Tan EM. Autoantibodies in pathology and cell biology. Cell. 1991;67:841–2.

    Article  CAS  PubMed  Google Scholar 

  2. von Muhlen CA, Tan EM. Autoantibody specificities in autoimmune rheumatic diseases. Rev Br Reumatol. 1994;34:173–94.

    Google Scholar 

  3. von Muhlen CA, Tan EM. Autoantibodies in the diagnosis of systemic rheumatic diseases. Sem Arthritis Rheum. 1995;24:323–58.

    Article  Google Scholar 

  4. Satoh M, Vazquez-Del Mercado M, Chan EK. Clinical interpretation of antinuclear antibody tests in systemic rheumatic diseases. Mod Rheumatol. 2009;19(3):219–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Andrade LEC, Chan EKL, Raska I, Peebles CL, Roos G, Tan EM. Human autoantibody to a novel protein of the nuclear coiled body: immunological characterization and cDNA cloning of p80-coilin. J Exp Med. 1991;173:1407–19.

    Article  CAS  PubMed  Google Scholar 

  6. Carcamo WC, Satoh M, Kasahara H, et al. Induction of cytoplasmic rods and rings structures by inhibition of the CTP and GTP synthetic pathway in mammalian cells. PloS One. 2011;6(12):e29690.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Covini G, Carcamo WC, Bredi E, von Muhlen CA, Colombo M, Chan EK. Cytoplasmic rods and rings autoantibodies developed during pegylated interferon and ribavirin therapy in patients with chronic hepatitis C. Antivir Ther. 2012;17(5):805–11.

    Article  CAS  PubMed  Google Scholar 

  8. Fritzler MJ, Chan EK. The discovery of GW bodies. Adv Exp Med Biol. 2013;768:5–21.

    Article  CAS  PubMed  Google Scholar 

  9. Dellavance AGJA, Cintra AFU, Ximenes AC, Nuccitelli B, von Mühlen CA, Bichara CD, Yano C, Carvalho DG, Bonfá ESDO, Guimarães FNC, Mundim HM, Pfrimer IAH, Rego J, Andrade LEC, Mesquita MM, Santiago MB, Silva NA, Miranda PJ, Leser P, Francescantonio PLC, Jarach R, Levy RA, Neves SPF, Cruvinel WM, Santos WS. The first Brazilian consensus for standardization of ANA in HEp-2 cells. J Bras Patol Med Labor. 2002;38(3):207–16.

    Google Scholar 

  10. Dellavance AGJA, Cintra AFU, Ximenes AC, Nuccitelli B, Taliberti BH, Moreira C, von Mühlen CA, Bichara CD, Santos CHR, Yano CM, Mangueira CP, Carvalho DG, Bonfá ESDO, Doi E, Guimarães FNC, Mundim HM, Araujo FI, Rego J, Vieira LEA, Poli L, Andrade LEC, Callado MR, Mesquita MM, Sugyiama M, Slhessarenko N, Silva NA, Carballo OG, Leser P, Francescantonio PLC, Jarach R, Xavier RM, Levy RA, Neves SPF, Cruvinel WM, Santos WS. II Brazilian Consensus on Antinuclear Antibodies in HEp-2 cells: definitions for standardization of autoantibody testing against the nucleus (ANA HEp-2), nucleolus, cytoplasm and mitotic apparatus, as well as its clinical associations. Rev Bras Reumatol. 2003;43(3):129–40.

    Article  Google Scholar 

  11. Dellavance AGJA, Nuccitelli B, Taliberti BH, von Mühlen CA, Bichara CD, Santos CHR, Bueno C, Yano CM, Mangueira CP, Carvalho DG, Cardoso E, Bonfá ESDO, Araujo FI, Rassi GG, Mundim HM, Bendet I, Rego J, Vieira LEA, Andrade LEC, Barbosa MOF, Sugyiama M, Santiago MB, Slhessarenko N, Francescantonio PLC, Jarach R, Suda R, Levy RA, Sampaio SO, Neves SPF, Cruvinel WM, Santos WS, Nobrega YKM. Third Brazilian Consensus for autoantibodies screening in HEp-2 cells (ANA): recommendations for standardization of autoantibodies screening trial in HEp-2 cells, quality control and clinical associations. Rev Bras Reumatol. 2009;49(2):89–109.

    Article  Google Scholar 

  12. Francescantonio P, Cruvinel W, Dellavance A, et al. IV Brazilian Guidelines for autoantibodies on HEp-2 cells. Rev Bras Reumatol. 2014;54(1):44–50.

    Article  PubMed  Google Scholar 

  13. Chan EKL, Damoiseaux J, Carballo G, et al. Report of the First International Consensus on Standardized Nomenclature of Antinuclear Antibody HEp-2 Cell Patterns (ICAP) 2014–2015. Front Immunol. 2015;6.

  14. Andrade LEC, Klotz W, Herold M, et al. International consensus on antinuclear antibody patterns: definition of the AC-29 pattern associated with antibodies to DNA topoisomerase I. Clin Chem Lab Med. 2018;56(10):1783–8.

    Article  CAS  PubMed  Google Scholar 

  15. Chan EK, Damoiseaux J, de Melo CW, et al. Report on the second International Consensus on ANA Pattern (ICAP) workshop in Dresden 2015. Lupus. 2016;25(8):797–804.

    Article  CAS  PubMed  Google Scholar 

  16. Herold M, Klotz W, Andrade LEC, et al. International Consensus on Antinuclear Antibody Patterns: defining negative results and reporting unidentified patterns. Clin Chem Lab Med. 2018;56(10):1799–802.

    Article  CAS  PubMed  Google Scholar 

  17. Damoiseaux J, Andrade LEC, Carballo OG, et al. Clinical relevance of HEp-2 indirect immunofluorescent patterns: the International Consensus on ANA patterns (ICAP) perspective. Ann Rheum Dis. 2019;78(7):879–89.

    Article  CAS  PubMed  Google Scholar 

  18. Carballo OIF, Ginaca A, Carabajal P, Costa M, Balbaryski J. First Argentine Consensus for Standardization of Antinuclear Antibodies by Indirect Immunofluorescence-HEp-2. Acta Bioquím Clín Latinoam. 2012;46(1):3–13.

    CAS  Google Scholar 

  19. Van Blerk MBX, Humbel R, Mewis A, Servais G, Tomasi JP, et al. Belgian recommendations on ANA, anti-dsDNA and anti-ENA antibody testing. Acta Clin Belg. 2014;69(2):83–6.

    Article  PubMed  Google Scholar 

  20. Cruvinel WDM, Andrade LEC, Von Mühlen CA, et al. V Brazilian consensus guidelines for detection of anti-cell autoantibodies on HEp-2 cells. Adv Rheumatol. 2019;59(1):28–39.

    Article  PubMed  Google Scholar 

  21. Moscoso H VC, Castillo AM, Galdames L, Mansilla I, Santis P. Recomendaciones para la determinación de anticuerpos antinucleares. Documentos técnicos para el laboratorio clínico. In: Instituto de Salud Publica MdlS GdC, ed. Santiago de Chile: Ministerio de la Salud; 2018:15.

  22. Musset L, Fabien N, Chyderiotis G, Olsson NO, Pham BN, Durey Dragon MA. Research and identification of antinuclear antibodies: analysis of a questionnaire from the European EASI group and confrontation of French practices to international recommendations. Ann Biol Clin. 2018;76(2):185–95.

    Google Scholar 

  23. Tozzoli R, Bizzaro N, Tonutti E, et al. Guidelines for the laboratory use of autoantibody tests in the diagnosis and monitoring of autoimmune rheumatic diseases. Am J Clin Pathol. 2002;117(2):316–24.

    Article  PubMed  Google Scholar 

  24. Cinquanta LBN, Villalta D, Morozzi G, Tonutti E, Bagnasco M, et al. Guidelines for the laboratory use of autoantibody tests in the diagnosis and monitoring of autoimmune rheumatic diseases. Revision 2015. Riv Ital Med Lab. 2015;11:205–24.

    Article  Google Scholar 

  25. Damoiseaux JCTJ, Derksen R, Hooijkaas H, Kallenberg C, Limburg P, Smeenk R, Hamann D. Laboratoriumdiagnostiek van ANA, anti-ds-DNA- en anti-ENA-antistoffen: aanbevelingen naar aanleiding van een enquête. Ned Tijdschr Klin Chem Labgeneesk. 2010;35(4):234–9.

    Google Scholar 

  26. Sack U, Conrad K, Csernok E, et al. Autoantibody detection using indirect immunofluorescence on HEp-2 cells. Ann N Y Acad Sci. 2009;1173:166–73.

    Article  CAS  PubMed  Google Scholar 

  27. Agmon-Levin N, Damoiseaux J, Kallenberg C, et al. International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies. Ann Rheum Dis. 2014;73(1):17–23.

    Article  CAS  PubMed  Google Scholar 

  28. Bizzaro N, Wiik A. Appropriateness in anti-nuclear antibody testing: from clinical request to strategic laboratory practice. Clin Exp Rheumatol. 2004;22(3):349–55.

    CAS  PubMed  Google Scholar 

  29. Bossuyt X, Louche C, Wiik A. Standardisation in clinical laboratory medicine: an ethical reflection. Ann Rheum Dis. 2008;67(8):1061–3.

    Article  PubMed  Google Scholar 

  30. Wiik AS, Hoier-Madsen M, Forslid J, Charles P, Meyrowitsch J. Antinuclear antibodies: a contemporary nomenclature using HEp-2 cells. J Autoimmun. 2010;35(3):276–90.

    Article  CAS  PubMed  Google Scholar 

  31. Standardization IOf. ISO 15189:2012 Medical Laboratories - requirements for quality and competence. In. ICS 03.120.10 Quality Management and quality assurance Geneva, Switzerland: Technical Committee ISO/TC 212 Clinical laboratory testing and in vitro diagnostic test systems; 2012:53.

  32. Damoiseaux J, Agmon-Levin N, Van Blerk M, et al. From ANA-screening to antigen-specificity: an EASI-survey on the daily practice in European countries. Clin Exp Rheumatol. 2014;32(4):539–46.

    PubMed  Google Scholar 

  33. de Almeida Brito F, Maria Eloi Santos S, Aparecida Ferreira G, et al. Diagnostic evaluation of ELISA and chemiluminescent assays as alternative screening tests to indirect immunofluorescence for the detection of antibodies to cellular antigens. Am J Clin Pathol. 2016;145(3):323–31.

    Article  PubMed  CAS  Google Scholar 

  34. Choi MY, Clarke AE, St Pierre Y, et al. Antinuclear antibody-negative systemic lupus erythematosus in an international inception cohort. Arthritis Care Res. 2019;71(7):893–902.

    Article  CAS  Google Scholar 

  35. Tan EM, Feltkamp TEW, Smolen JS, et al. Range of antinuclear antibodies in “healthy” individuals. Arthritis Rheum. 1997;40(9):1601–11.

    Article  CAS  PubMed  Google Scholar 

  36. Van Hoovels L, Schouwers S, Van den Bremt S, Bossuyt X. Variation in antinuclear antibody detection by automated indirect immunofluorescence analysis. Ann Rheum Dis. 2019;78(6):e48.

    Article  PubMed  Google Scholar 

  37. Meroni PL, Biggioggero M, Pierangeli SS, Sheldon J, Zegers I, Borghi MO. Standardization of autoantibody testing: a paradigm for serology in rheumatic diseases. Nat Rev Rheumatol. 2014;10(1):35–43.

    Article  CAS  PubMed  Google Scholar 

  38. Lichtman JW, Conchello JA. Fluorescence microscopy. Nat Methods. 2005;2(12):910–9.

    Article  CAS  PubMed  Google Scholar 

  39. Mariz HA, Sato EI, Barbosa SH, Rodrigues SH, Dellavance A, Andrade LE. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis Rheum. 2011;63(1):191–200.

    Article  CAS  PubMed  Google Scholar 

  40. Satoh M, Chan EK, Ho LA, et al. Prevalence and sociodemographic correlates of antinuclear antibodies in the United States. Arthritis Rheum. 2012;64(7):2319–27.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Brito FASS, Ferreira GA, Pedrosa W, Gradisse J, Costa LC, Neves SPF. Detection of anti-nuclear antibodies by indirect immunofluorescence on HEp2-cells: setting the appropriate screening dilution for the diagnosis of autoimmune rheumatic diseases. Rev Bras Reumatol. 2013;54(1):13–20.

    Article  Google Scholar 

  42. Terao C, Ohmura K, Yamada R, et al. Association between antinuclear antibodies and the HLA class II locus and heterogeneous characteristics of staining patterns: the Nagahama study. Arthritis & rheumatology. 2014;66(12):3395–403.

    Article  CAS  Google Scholar 

  43. Agustinelli RA, Rodrigues SH, Mariz HA, Prado MS, Andrade LEC. Distinctive features of positive anti-cell antibody tests (indirect immunofluorescence on HEp-2 cells) in patients with non-autoimmune diseases. Lupus. 2019;28(5):629–34.

    Article  CAS  PubMed  Google Scholar 

  44. Prado MS, Dellavance A, Rodrigues SH, Marvulle V, Andrade LEC. Changes in the result of antinuclear antibody immunofluorescence assay on HEp-2 cells reflect disease activity status in systemic lupus erythematosus. Clin Chem Lab Med. 2020;58(8):1271–81.

    Article  CAS  PubMed  Google Scholar 

  45. Fritzler MJ. The antinuclear antibody test: last or lasting gasp? Arthritis Rheum. 2011;63(1):19–22.

    Article  PubMed  Google Scholar 

  46. Shovman O, Gilburd B, Chayat C, et al. Prevalence of anti-DFS70 antibodies in patients with and without systemic autoimmune rheumatic diseases. Clin Exp Rheumatol. 2018;36(1):121–6.

    PubMed  Google Scholar 

  47. Mahler M, Andrade LE, Casiano CA, Malyavantham K, Fritzler MJ. Anti-DFS70 antibodies: an update on our current understanding and their clinical usefulness. Expert Rev Clin Immunol. 2019;15(3):241–50.

    Article  CAS  PubMed  Google Scholar 

  48. von Muhlen CA FM, Chan EKL. Clinical and laboratory evaluation of systemic rheumatic diseases. In: MR MRP, ed. Henry’s clinical diagnosis and management by laboratory methods. 23 ed. St. Louis, Missouri: Elsevier; 2016:993–1015.

  49. Bossuyt X, De Langhe E, Borghi MO, Meroni PL. Understanding and interpreting antinuclear antibody tests in systemic rheumatic diseases. Nat Rev Rheumatol. 2020;16(12):715–26.

    Article  CAS  PubMed  Google Scholar 

  50. Damoiseaux J, von Muhlen CA, Garcia-De La Torre I, et al. International consensus on ANA patterns (ICAP): the bumpy road towards a consensus on reporting ANA results. Auto Immun Highlights. 2016;7(1):1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Berg BA, Klein R. Antimitochondrial antibodies in primary biliary cirrhosis and other disorders: definition and clinical relevance. Dig Dis. 1992;10:85–101.

    Article  CAS  PubMed  Google Scholar 

  52. Gao L, Tian X, Liu B, Zhang F. The value of antinuclear antibodies in primary biliary cirrhosis. Clin Exp Med. 2008;8(1):9–15.

    Article  CAS  PubMed  Google Scholar 

  53. Hoffman IE, Peene I, Meheus L, et al. Specific antinuclear antibodies are associated with clinical features in systemic lupus erythematosus. Ann Rheum Dis. 2004;63(9):1155–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Sarfaraz S, Anis S, Ahmed E, Muzaffar R. Clinical significance of anti-ribosomal P protein antibodies in patients with lupus nephritis. Rev Recent Clin Trials. 2018;13(4):281–6.

    Article  CAS  PubMed  Google Scholar 

  55. Ghirardello A, Bassi N, Palma L, et al. Autoantibodies in polymyositis and dermatomyositis. Curr Rheumatol Rep. 2013;15(6):335.

    Article  PubMed  CAS  Google Scholar 

  56. Gunawardena H, Betteridge ZE, McHugh NJ. Myositis-specific autoantibodies: their clinical and pathogenic significance in disease expression. Rheumatology (Oxford). 2009;48(6):607–12.

    Article  CAS  Google Scholar 

  57. Bizzaro NBM, Tozzoli R, Brusca I, Cinquanta L, Tampoia M, Deleonardi G, et al. Choosing wisely in autoinmunologia: le 5 Proposte del Gruppo di Studio in Autoinmunologia della SIPMeL. Riv Ital Med Lab. 2018;14(1):11–9.

    Article  Google Scholar 

  58. Palterer B, Vitiello G, Carraresi A, Giudizi MG, Cammelli D, Parronchi P. Bench to bedside review of myositis autoantibodies. Clin Mol Allergy. 2018;16:5.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  59. Carcamo WC, Ceribelli A, Calise SJ, et al. Differential reactivity to IMPDH2 by anti-rods/rings autoantibodies and unresponsiveness to pegylated interferon-alpha/ribavirin therapy in US and Italian HCV patients. J Clin Immunol. 2013;33(2):420–6.

    Article  CAS  PubMed  Google Scholar 

  60. Tebo AE, Schmidt RL, Kadkhoda K, et al. The antinuclear antibody HEp-2 indirect immunofluorescence assay: a survey of laboratory performance, pattern recognition and interpretation. Auto Immun Highlights. 2021;12(1):4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Van Hoovels L, Broeders S, Chan EKL, et al. Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey. Auto Immun Highlights. 2020;11(1):17.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  62. Liberal R, Grant CR, Longhi MS, Mieli-Vergani G, Vergani D. Diagnostic criteria of autoimmune hepatitis. Autoimmun Rev. 2014;13(4–5):435–40.

    Article  CAS  PubMed  Google Scholar 

  63. Liberal R, Krawitt EL, Vierling JM, Manns MP, Mieli-Vergani G, Vergani D. Cutting edge issues in autoimmune hepatitis. J Autoimmun. 2016;75:6–19.

    Article  CAS  PubMed  Google Scholar 

  64. Liberal R, Mieli-Vergani G, Vergani D. Clinical significance of autoantibodies in autoimmune hepatitis. J Autoimmun. 2013;46:17–24.

    Article  CAS  PubMed  Google Scholar 

  65. Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis. 2019;78(9):1151–9.

    Article  PubMed  Google Scholar 

  66. Agmon-Levin N, Shapira Y, Selmi C, et al. A comprehensive evaluation of serum autoantibodies in primary biliary cirrhosis. J Autoimmun. 2010;34(1):55–8.

    Article  CAS  PubMed  Google Scholar 

  67. Sebode M, Weiler-Normann C, Liwinski T, Schramm C. Autoantibodies in autoimmune liver disease-clinical and diagnostic relevance. Front Immunol. 2018;9:609.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  68. Bossuyt X, Fieuws S. Detection of antinuclear antibodies: added value of solid phase assay? Ann Rheum Dis. 2014;73(3):e10.

    Article  PubMed  Google Scholar 

  69. Meroni PL, Chan EK, Damoiseaux J, et al. Unending story of the indirect immunofluorescence assay on HEp-2 cells: old problems and new solutions? Ann Rheum Dis. 2019;78(6):e46.

    Article  PubMed  Google Scholar 

  70. Pregnolato F, Borghi MO, Meroni PL, Forum Interdisciplinare per la Ricerca sulle Malattie Autoimmuni Study G. Pitfalls of antinuclear antibody detection in systemic lupus erythematosus: the positive experience of a national multicentre study. Ann Rheum Dis. 2019;78(6):e50.

    Article  PubMed  Google Scholar 

  71. Infantino M, Carbone T, Manfredi M, et al. A new diagnostic algorithm for pattern-oriented autoantibody testing according to the ICAP nomenclature: a pilot study. Autoimmun Rev. 2020;19(8):102588.

    Article  CAS  PubMed  Google Scholar 

  72. Mahler M, Hanly JG, Fritzler MJ. Importance of the dense fine speckled pattern on HEp-2 cells and anti-DFS70 antibodies for the diagnosis of systemic autoimmune diseases. Autoimmun Rev. 2012;11(9):642–5.

    Article  CAS  PubMed  Google Scholar 

  73. Mahler M, Parker T, Peebles CL, et al. Anti-DFS70/LEDGF antibodies are more prevalent in healthy individuals compared to patients with systemic autoimmune rheumatic diseases. J Rheumatol. 2012;39(11):2104–10.

    Article  PubMed  Google Scholar 

  74. Miyara M, Albesa R, Charuel JL, et al. Clinical phenotypes of patients with anti-DFS70/LEDGF antibodies in a routine ANA referral cohort. Clin Dev Immunol. 2013;2013:703759.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  75. Bentow C, Fritzler MJ, Mummert E, Mahler M. Recognition of the dense fine speckled (DFS) pattern remains challenging: results from an international internet-based survey. Auto Immun Highlights. 2016;7(1):8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  76. Fritzler MJ. Choosing wisely: review and commentary on anti-nuclear antibody (ANA) testing. Autoimmun Rev. 2016;15(3):272–80.

    Article  PubMed  Google Scholar 

  77. Sack U, Bossuyt X, Andreeva H, et al. Quality and best practice in medical laboratories: specific requests for autoimmunity testing. Auto Immun Highlights. 2020;11(1):12.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors wish to express their gratitude to all persons who collaborated with examples of ANA Test Reports and/or with comments regarding ANA reporting in their respective laboratories and countries.

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Authors and Affiliations

  1. Hospital Moinhos de Vento, Rheumatology Unit, Porto Alegre, Brazil

    Carlos Alberto von Mühlen

  2. Consultant in Rheumatology and Clinical Pathology, San Diego, USA

    Carlos Alberto von Mühlen

  3. Department of Immunology and Rheumatology, Hospital General de Occidente, Universidad de Guadalajara, Guadalajara, Mexico

    Ignacio Garcia-De La Torre

  4. Immunology and Allergy Laboratory, San Giovanni Di Dio Hospital, Florence, Italy

    Maria Infantino

  5. Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, The Netherlands

    Jan Damoiseaux

  6. Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil

    Luis E. C. Andrade

  7. Immunology Division, Fleury Medicine and Health Laboratories, São Paulo, Brazil

    Luis E. C. Andrade

  8. Laboratory of Immunology, Hospital Carlos G. Durand, Buenos Aires, Argentina

    Orlando Gabriel Carballo

  9. Department of Microbiology and Immunology, Instituto Universitario del Hospital Italiano, Buenos Aires, Argentina

    Orlando Gabriel Carballo

  10. Institute of Immunology, Technical University of Dresden, Dresden, Germany

    Karsten Conrad

  11. Pontifícia Universidade Católica de Goiás, Goiânia, Brazil

    Paulo Luiz Carvalho Francescantonio & Wilson de Melo Cruvinel

  12. Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada

    Marvin J. Fritzler

  13. Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria

    Manfred Herold & Werner Klotz

  14. Ijinkai Takeda General Hospital, and Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Tsuneyo Mimori

  15. Department of Clinical Nursing, University of Occupational and Environmental Health, Kitakyushu, Japan

    Minoru Satoh

  16. Department of Immunology, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France

    Lucile Musset

  17. Department of Oral Biology, University of Florida, Gainesville, FL, USA

    Edward K. L. Chan

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  1. Carlos Alberto von Mühlen
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  2. Ignacio Garcia-De La Torre
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  3. Maria Infantino
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  16. Edward K. L. Chan
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Carlos von Mühlen and Edward Chan. The first draft of the manuscript was written by Carlos von Mühlen and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Carlos Alberto von Mühlen.

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von Mühlen, C. ., Garcia-De La Torre, I., Infantino, M. et al. How to report the antinuclear antibodies (anti-cell antibodies) test on HEp-2 cells: guidelines from the ICAP initiative. Immunol Res 69, 594–608 (2021). https://doi.org/10.1007/s12026-021-09233-0

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