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001-es BibID:BIBFORM075565
Első szerző:Nagy Gábor (laboratóriumi szakorvos, laboratóriumi hematológus és immunológus)
Cím:Diagnostic algorithm for antinuclear antibody testing : clinical and financial considerations / G. Nagy, I. Csípő, E. Gyimesi, J. Tóth, S. Demeter, P. Antal-Szalmás
Dátum:2018
Megjegyzések:The diagnostics of autoimmune rheumatic diseases strongly depends on laboratory tests, dominantly on autoantibody determinations. Several techniques and assay types are available for evaluation of the autoantibody profile of these patients. The most widely used indirect immunofluorescence (IIF) assay on HEp-2 cells can identify dozens of antinuclear (ANA) and anti-cytoplasmic autoantibodies, while ELISA-s or immunoblots utilizing mixed or single antigens can identify the exact specificity of them. Since the application (replacement and sequential order) of these tests is rather ambiguous we developed an algorithm for the most frequently used antinuclear and anti-cytoplasmic autoantibodies and evaluated clinical and financial efficacy of this novel system. The number and results of autoantibody determinations (ANA HEp-2 IIF, anti-dsDNA and anti-ENA tests) between January and June, 2017 were collected from our laboratory information system (GLIMS). The theoretical number of autoantibody tests was recalculated along the following rule: anti-dsDNA and anti-ENA tests were performed only if ANA HEp-2 IIF was positive. Separate analyses were performed taking into account the ANA HEp-2 IIF patterns and titers, too. Our results showed that the ANA HEp-2 IIF guided selection of anti-dsDNA and anti-ENA ELISAs could reduce the number of anti-dsDNA and anti-ENA tests by 48% and 56%, sparing about 7.1M HUF per year. The rate of ANA HEp-2 IIF negative but anti-dsDNA positive cases was 1.8%, meaning 64 samples, from which 16 patients (0.45%) had significantly higher (>2x URL) anti-dsDNA value. The rate of ANA HEp-2 IIF negative but anti-ENA positive samples was 1.1% (56 cases). 14 and 19 of these patients showed only anti-SS-A or anti-Jo-1 positivity, known to be weakly reactive on HEp-2 cells. The described sequential application of ANA HEp-2 IIF assay, anti-dsDNA and anti-ENA ELISAs provided high clinical efficacy and proved to be cost-effective.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
Megjelenés:Clinical Chemistry and Laboratory Medicine. - 56 : 9 (2018), p. eA139-eA140. -
További szerzők:Csípő István (1953-) (vegyész) Gyimesi Edit (1957-) (klinikai biokémikus, vegyész) Tóth Judit (1978-) (laboratóriumi szakorvos) Demeter S. Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos)
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Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:BIBFORM071357
Első szerző:Nagy Gábor (laboratóriumi szakorvos, laboratóriumi hematológus és immunológus)
Cím:The role of automated microscopes and computer aided pattern recognition in autoantibody detection by indirect / G. Nagy, I. Csípő, J. Kappelmayer, P. Antal-Szalmás
Dátum:2016
Megjegyzések:The role of automated microscopes and computer aided pattern recognition in autoantibody detection by indirectimmunofluorescence assaysG. Nagy, I. Csípő, J. Kappelmayer, P. Antal-SzalmásDepartment of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, HungaryIndirect immunofluorescene assays (IFA) are versatile and sensitive solid phase tests for detecting autoantibodies needed to confirm the diagnosisof autoimmune diseases. Utilization of cells or tissue sections as the antigen source makes these assays capable of detecting antibodiesto delicate epitopes masked in other tests such as enzyme linked immunosorbent assay or immunoblot. However, conventional microscopicevaluation of the fluorescent patterns is time consuming and prone to transcription error.In our work we compared four automated fluorescence microscopes (Helios-Aesku Diagnostics, NovaView-Werfen Group, Europattern-Euroimmun, Image Navigator-Immunoconcept) regarding the number of available antigen substrates, specifications of the image capture andanalysis system, extent of the automation, patient safety and impact on the daily routine workflow.All four systems are able to detect antinuclear (ANA) and anti-cytoplasmic antibodies on HEp-2 epithelial cells (positive/negative discriminationonly) while Europattern and NovaView also help with the recognition of the most frequent ANA patterns. The sensitivity ofANA positive/negative discrimination is rather similar between the systems (around 95%), while the specificity varies between 85 to 95%.The capability for detection of anti-neutrophil cytoplasmic antibodies (ANCA) and image capture from other substrates like rat liver-kidneystomach(LKS) shows variability between the different analyzers. Similarly, the throughput, titer-estimation and physical parameters differsignificantly.Automation of the indirect immunofluorescence autoantibody testing is beneficial. In addition to slide processing, several fluorescencemicroscopes are available now which are able to digitize and archive IFA images. Their image analysis software helps to evaluate samples,making the indirect immunofluorescence method less laborious and error-prone.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
Megjelenés:Clinical Chemistry and Laboratory Medicine 54 : 10 (2016), p. 202. -
További szerzők:Csípő István (1953-) (vegyész) Kappelmayer János (1960-) (absztraktok) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos)
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Intézményi repozitóriumban (DEA) tárolt változat
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