This is an issue that the ICAP committee has discussed extensively
but there has been no consensus to date. In many countries, sera showing
cytoplasmic staining alone are considered ANA test positive, while in
other countries, such sera are considered ANA-negative but cytoplasmic
positive. In other jurisdictions, cytoplasmic staining is not reported
at all because it is not strictly definable as nuclear staining. There
is wide agreement that, sera with cytoplasmic staining alone should not
be ignored (1). Other discussions on the topic has suggested renaming he
ANA test as anti-cellular antibodies (1), which is consistent with the
nomenclature that ICAP has chosen for the various IFA patterns (i.e. AC =
anti-cellular). How you report this remains somewhat a local issue.
However, whether it is identified as ANA positive or negative has
implications for some disease classification criteria. ICAP is working
towards a consensus recommendation in the coming year.
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Jose, A. Radice, C. Eriksson, O. Hultgren, M. Viander, M. Khamashta, S.
Regenass, L. E. Coelho Andrade, A. Wiik, A. Tincani, J. Ronnelid, D. B.
Bloch, M. J. Fritzler, E. K. Chan, I. Garcia-de la Torre, K. N.
Konstantinov, R. Lahita, M. Wilson, O. Vainio, N. Fabien, R. A. Sinico,
P. Meroni, and Y. Shoenfeld. International recommendations for the
assessment of autoantibodies to cellular antigens referred to as
anti-nuclear antibodies. Ann.Rheum.Dis. 73:17-23, 2014.
Date: March 14, 2019