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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

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Volume 47, Issue 1


Current practices in antinuclear antibody testing: results from the Belgian External Quality Assessment Scheme

Marjan Van Blerk / Christel Van Campenhout / Xavier Bossuyt / Jean Duchateau / René Humbel / Geneviève Servais / Jean-Paul Tomasi / Adelin Albert / Wim Coucke / Jean-Claude Libeer
Published Online: 2008-12-10 | DOI: https://doi.org/10.1515/CCLM.2009.021


Background: This study aimed to assess the state-of-the-art of antinuclear antibody (ANA) testing as practiced in the Belgian and Luxembourg laboratories, using the results obtained in the Belgian National External Quality Assessment Scheme from 2000 to 2005.

Methods: During this period, nine samples with different specificities were sent for analysis. Participants were surveyed for methodology used and were asked to report staining pattern and titer of ANAs. In 2002, an attempt was made to improve the comparability of quantitative ANA results by the provision of a commercial reference material and to relate observed differences to methodology.

Results: With one exception, all participants employed a microscope-based indirect immunofluorescence assay with human epithelial cell line 2 cells. Most laboratories were accurate in describing the pattern. The percentage of unacceptable answers was greater for samples with borderline levels of antibody and for samples showing a cytoplasmic pattern. An improvement in the detection of anticentromere antibodies was observed. For all samples, a wide range of titers was reported. The provision of the secondary reference preparation led to improved inter-laboratory concordance. Comparison of methodology variables revealed a correlation between unstandardized titers and the power of the lamp of the microscope and the use of a dark room.

Conclusions: The EQAS results presented in this work provide valuable insights into the state of the art of ANA testing as practiced in the Belgian and Luxembourg Laboratories and illustrate the important value of a national EQAS for ANA testing as a tool to improve performance and interlaboratory comparability of laboratory results.

Clin Chem Lab Med 2009;47:102–8.

Keywords: antinuclear antibodies; external quality assessment; indirect immunofluorescence; quality control; standardization

About the article

Corresponding author: Marjan Van Blerk, Wetenschappelijk Instituut Volksgezondheid, Klinische Biologie, J. Wytsmanstraat 14, 1050 Brussels, Belgium Phone: +32-2-6425383, Fax: +32-2-6425645,

Received: 2008-07-11

Accepted: 2008-10-13

Published Online: 2008-12-10

Published Online: 2008-12-10

Published in Print: 2009-01-01

Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 47, Issue 1, Pages 102–108, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2009.021.

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