Autor(s): E. Tonutti, D. Visentini, N. Bizzaro
The autoimmune laboratory has become an essential part of modern medicine in terms of organizational, interdisciplinary and competency models. The clinical pathologist involved in this diagnostic discipline must possess the necessary competencies in order to choose the most appropriate tests and methods, and to interpret the results in view of the complexity of the diagnostic issues. In autoimmunology, the interpretive comment of the results is an essential tool that provides useful information for both correct data interpretation and diagnostic developments. The value of the interpretive comment is clear in the case of methodologies capable of showing autoantibody plurispecificities evidencing unexpected and non-pertinent markers. An unexpected autoantibody result must always be flagged in case of markers with high specificity and positive predictive value. The interpretive comment is also fundamental in other situations: in the presence of an autoantibodies pattern with scarce diagnostic value or with relevant clinical correlation; in the presence of discordant results when multiple methods are used to determine the same antibody; and in the case of further diagnostic studies conducted independently by the laboratory. The interpretive comment must take into consideration the patient’s sex and age in addition to the available laboratory parameters, it must indicate the clinical and diagnostic correlation of positive antibodies and, finally, it must indicate the appropriate follow up procedures needed to complete the diagnostic process.