title: IV Brazilian guidelines for autoantibodies on HEp-2 cells.
abstract: OBJECTIVE
  The Fourth Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells (ANA) was held in Vitória, Espírito Santo, and aimed to discuss strategies and recommendations about the technique, standardization, interpretation and quality control of the indirect immunofluorescence reaction on HEp-2 cells.
  
  
  METHODS
  Twenty three ANA experts from university centers and private laboratories in different areas from Brazil discussed and agreed upon recommendations for the fourth edition of the Brazilian Consensus for Autoantibodies Screening in HEp-2 Cells.
  
  
  CONCLUSIONS
  The 4th ANA Consensus included three novel patterns into the existing algorithm (cytoplasmic Rods and Rings, nuclear Quasi-homogeneous, and CENP-F). Emphasis was given to the need of attention in describing the peculiar mixed pattern elicited by anti-DNA topoisomerase I (Scl-70) autoantibodies, comprising nuclear fine specked, nucleolar homogeneous pattern, NOR staining in metaphase plates, and cytoplasmic fine speckled patterns. The group also emphasized the need for continuous quality control in indirect immunofluorescence assays, the establishment of screening dilutions, as well as conjugate titration. An alert was made regarding the heterogeneity of commercial kits in defining patterns and the use of solid phase methodologies to determine the presence of autoantibodies.
authors.affiliation: Pontifícia Universidade Católica de Goiás, Goiânia, GO, Brasil.
authors.forename: Paulo Luiz Carvalho
authors.initials: PL
authors.lastname: Francescantonio
authors.affiliation: Pontifícia Universidade Católica de Goiás, Goiânia, GO, Brasil.
authors.forename: Wilson de Melo
authors.initials: Wde M
authors.lastname: Cruvinel
authors.affiliation: Fleury Medicina e Saúde, São Paulo, SP, Brasil.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Dellavance
authors.affiliation: Fleury Medicina e Saúde, São Paulo, SP, Brasil.
authors.forename: Luis Eduardo Coelho
authors.initials: LE
authors.lastname: Andrade
authors.affiliation: Serviço de Reumatologia, Hospital das Clínicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil.
authors.forename: Ben Hur
authors.initials: BH
authors.lastname: Taliberti
authors.affiliation: Centro de Diagnósticos Médicos e Rheuma Clínica de Doenças Reumáticas de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: von Mühlen
authors.affiliation: Amaral Costa Medicina Diagnóstica, Belém, PA, Brasil.
authors.forename: Carlos David Araújo
authors.initials: CD
authors.lastname: Bichara
authors.affiliation: Laboratórios de Investigação Médica, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Cleonice
authors.initials: C
authors.lastname: Bueno
authors.affiliation: Laboratório Central, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Cristóvão Luis Pitangueira
authors.initials: CL
authors.lastname: Mangueira
authors.affiliation: Instituto Hermes Pardini, Belo Horizonte, MG, Brasil.
authors.forename: Darlene Gonçalves
authors.initials: DG
authors.lastname: Carvalho
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Eloísa S D de O
authors.initials: ES
authors.lastname: Bonfá
authors.affiliation: Instituto Hermes Pardini, Belo Horizonte, MG, Brasil.
authors.forename: Fabiano de Almeida
authors.initials: Fde A
authors.lastname: Brito
authors.affiliation: Universidade Católica de Brasília, Brasília, DF, Brasil.
authors.forename: Flávia Ikeda e
authors.initials: FI
authors.lastname: Araújo
authors.affiliation: Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO, Brasil.
authors.forename: Jozelia
authors.initials: J
authors.lastname: Rêgo
authors.affiliation: Fleury Medicina e Saúde, São Paulo, SP, Brasil.
authors.forename: Kaline Medeiros Costa
authors.initials: KM
authors.lastname: Pereira
authors.affiliation: Universidade do Sul de Santa Catarina, Florianópolis, SC, Brasil.
authors.forename: Lisiane Maria Enriconi
authors.initials: LM
authors.lastname: dos Anjos
authors.affiliation: Universidade Federal do Espírito Santo, Vitória, ES, Brasil.
authors.forename: Maria de Fatima
authors.initials: Mde F
authors.lastname: Bissoli
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.
authors.forename: Mittermayer Barreto
authors.initials: MB
authors.lastname: Santiago
authors.affiliation: Grupo DASA, São Paulo, SP, Brasil.
authors.forename: Natalya Zaidan
authors.initials: NZ
authors.lastname: Maluf
authors.affiliation: Pontifícia Universidade Católica de Goiás, Goiânia, GO, Brasil.
authors.forename: Rossana Rassi
authors.initials: RR
authors.lastname: Alvarenga
authors.affiliation: Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
authors.forename: Suzane Pretti Figueiredo
authors.initials: SP
authors.lastname: Neves
authors.affiliation: Universidade Federal do Espírito Santo, Vitória, ES, Brasil.
authors.forename: Valeria
authors.initials: V
authors.lastname: Valim
authors.affiliation: Escola Superior de Ciências da Saúde do Distrito Federal, Brasília, DF, Brasil.
authors.forename: Wilton Silva
authors.initials: WS
authors.lastname: dos Santos
mesh_terms: D001323:Autoantibodies / Q000097:blood* / Q000302:isolation & purification*; D001938:Brazil; D045744:Cell Line, Tumor / Q000276:immunology*; D004847:Epithelial Cells / Q000145:classification / Q000276:immunology*; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D017410:Practice Guidelines as Topic
chemical_list: D001323:Autoantibodies