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pISSN 2950-9114 eISSN 2950-9122
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Original Article

Lab Med Qual Assur 2023; 45(1): 29-33

Published online March 31, 2023


Copyright © Korean Association of External Quality Assessment Service.

A Survey on Antinuclear Antibodies Testing in Korea

Kyeong-Hee Kim

Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea

Correspondence to:Kyeong-Hee Kim
Department of Laboratory Medicine, Dong-A University Hospital, Dong-A University College of Medicine, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea
Tel +82-51-240-2850
E-mail progreen@dau.ac.kr

Received: October 17, 2022; Revised: December 1, 2022; Accepted: December 2, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: Antinuclear antibodies (ANA) detected by indirect immunofluorescence assay (IFA) on HEp-2 cells are important for the diagnosis of systemic rheumatic diseases. ANA is an entry criterion in the 2019 classification criteria for systemic lupus erythematosus (SLE). The International Consensus on ANA Patterns (ICAP) and computer-aided immunofluorescence microscopy (CAIFM) and have been introduced for ANA interpretation. This study aimed investigate the status of ANA testing in Korea.
Methods: The study conducted an e-mail survey in July 2019. The survey containing 15 items were emailed to 49 clinical pathologists at 42 tertiary referral hospitals and seven reference laboratories. A total of 37 pathologists replied (response rate: 75.5%). Statistical analysis was performed based on the responses from 36 institutions because one hospital did not perform ANA testing.
Results: All the laboratories performed ANA testing by IFA on Hep-2 cells. Of these, 21 laboratories (58%) used 1:40 as the screening dilution titer, while the titer of final dilution varied. Ten of 12 laboratories using CAIFM applied it to negative/positive determination, and 59% (n=12 laboratories) used it for reading the fluorescence pattern. Moreover, 33 clinical pathologists (92%) who was familiar with ICAP responded. Furthermore, 33 laboratories (92%) responded that they do not use the anti-cell (AC) code, while 16 laboratories (48%) indicated an intention to use the AC code.
Conclusions: The use of 1:40 dilution screening titer for the diagnosis of SLE in laboratories needs to be considered. The findings of this study may be used to better inform standardized ANA reporting and for establishing the Korean ANA reporting guidelines.

Keywords: Antinuclear antibody, International Consensus on ANA Patterns, HEp-2 cell, Immunofluorescence assay, Korea

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