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Current practice in laboratory diagnostics of autoimmune diseases in Croatia. Survey of the Croatian Society of Medical Biochemistry and Laboratory Medicine Working group for laboratory diagnostics of autoimmune diseases.

Laboratory medicine of autoimmune diseases is a growing discipline of laboratory medicine in general, and many laboratories expand their panel of tests with new methodologies for autoantibody detection. Methods in laboratory medicine of autoimmune diseases differ in many aspects like the antigen profiles, sensitivity and specificity (1). Limitations like the lack of standardized reference samples of defined specificities and different sources of antigens (recombinant vs. native) are the main source of results discrepancy between different methods. Very heterogeneous manner of result reporting is the consequence of both lack of nomenclature uniformity and consensus regarding result interpretation. Finally, the lack of experience and education of laboratory personnel in the diagnostics of certain autoimmune diseases, as well as an unawareness of a method limitation often results in confusion for clinicians. Therefore, standardization and harmonization in this field of laboratory diagnostic is essential (2). Efforts were made to provide the recommendations for humoral autoimmune diagnostics that recently resulted with International recommendations for the assessment of anti-nuclear antibody testing published by the European Autoimmunity Standardization Initiative (EASI) (3). For most systemic and organ-specific autoimmune diseases diagnostic criteria or classification criteria have been introduced (4- 12). Autoantibodies included in those criteria are an important tool for diagnosis of autoimmune diseases. This prompted the initiative from Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) to form a Working group (WG) for laboratory diagnostics of autoimmune diseases with following goals: to screen the current practice in performing laboratory medicine of autoimmune diseases in Croatia, to identify the main problems and accordingly propose the recommendations that would improve and harmonize laboratory medicine of autoimmune diseases. The aim of the study was to gather information about the methodology, interpretation and algorithms used in laboratory medicine of autoimmune diseases in Croatia. WG designed two-step questionnaires in order to obtain that information. This study summarises the outcome of these questionnaires and provides the insight into the main problems and sources of heterogeneity in performance of autoantibody testing.

Autoantibodies ; Autoimmune diseases ; Survey

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