An Argument for performing Anti- Nuclear Ab assays by Indirect Immunofluorescence (IFA)
In 2008, the American College of Rheumatology officially recommended the Indirect Immunofluorescence (IFA) methodology for Anti-Nuclear Ab testing. Since 1980, RDL Reference Laboratory performs our Anti-Nuclear Ab (ANA) assay by IFA exclusively.
Using the IFA methodology our technologists look at the cytoplasm carefully, and if they suspect mitochondrial antigen, the specimen is tested by the ELISA methodology for the Anti-Mitochondrial Ab. If the ELISA assay confirms the presence of mitochondrial ab the diagnosis of Primary Biliary Cirrhosis (PBC) is suspected and may possibly be present at the time. This process provides RDL with the capability of diagnosing PBC often many years before the clinical disease onset*.
Also, during the microscopic examination of serum for ANA by IFA, if RDL technologists suspect Ribosomal P or Jo-1 in the cytoplasm, they also confirm either antibody by performing it by the ELISA methodology, providing the clinician important information.
* This raises the important issue: Should a patient be put on Ursodiol (Actigall) to prevent disease progression? For more information regarding this matter, go to http://www.rheumatology.org/practice/practice_issues/2009/2009_03.asp.