Research and identification of antinuclear antibodies: analysis of a questionnaire from the European EASI group and confrontation of French practices to international recommendations

Antinuclear antibodies (ANA) are prescribed as first-line autoantibodies in suspicion of mainly systemic autoimmune diseases. They include antibodies recognizing antigenic structures localized in the nucleus of cells, but also in the cytoplasm, at the membranes or transitional structures related to the cell cycle. Their research is based on screening and identification tests. For these tests, there is little or no standardization and harmonization of professional practices is necessary. From a questionnaire sent to healthcare professionals involved in the realization and interpretation of tests of autoimmunity, an over-wiew of routine practices for the research of the ANA and their identification, was directed by the EASI Group International. Here, we present the results of the survey carried out in France. The analysis of these results faced with that of other countries as well as international recommendations allowed us to propose a synthesis of the main recommendations adapted to the regulatory texts of the NABM in France. These recommendations are addressed to those who prescribe, to those who perform biological analysis and to clinicians and biologists who interpret the results. They allow better understanding and admitting the methodological differences and their evolutions, to encourage the choice of the best technique based on the clinical context, to inform the clinician of the characteristics of the tests used.