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Chapter 86 : Introduction
Systemic autoimmune diseases are often associated with the production of autoantibodies that recognize a diverse array of cytoplasmic and nuclear antigens. These autoantibodies are used as adjuncts in the diagnosis of autoimmune disease, for monitoring disease activity and severity, and for predicting the outcome of autoimmune disease. As the diagnosis of systemic autoimmune disease is not always straightforward, autoantibody testing has the potential to improve our ability to diagnose complex autoimmune disorders. However, autoantibody test results, particularly those based on enzyme-linked immunosorbent assays (ELISAs) and other solid-phase assays, must be interpreted with caution due to their high sensitivity and the possibility of false-positive results. It is important to interpret the results of autoantibody tests in light of both the clinical context and the methodology employed. In some cases, confirmatory testing, analogous to the use of Western blotting to verify positive ELISA test results for HIV infection, is warranted.