Fig. 1

Examples illustrating the recommendations for reporting of ANA test results. The report consists of three categories: the type of assay used, the test results (positive/negative, pattern, and antibody level), and the advice for the clinician. In proposal 1 (left), cytoplasmic (and mitotic) patterns are considered ANA positive, while in proposal 2 (right), cytoplasmic (and mitotic) patterns are considered ANA negative. The examples shown illustrate alternate possibilities according to the rules in each proposal for reporting ANA test results. If the test result is negative (a), this is reported as such in both proposals. If only a cytoplasmic staining is observed (b), the result is reported as ANA positive in proposal 1 and as ANA negative in proposal 2. The items positive and negative are highlighted to emphasize the difference in the proposals. In both proposals this result is followed by the statement of the cytoplasmic pattern and antibody level (titer). If a combination of nuclear and cytoplasmic patterns is observed (c), the result is reported as positive in both proposals because of the nuclear staining. According to the rule that patterns are reported in the sequence nuclear—cytoplasmic—mitotic, irrespective of the antibody level, the nuclear pattern is mentioned first even when the antibody level of the cytoplasmic pattern is higher. If a combination of different nuclear patterns is observed (d), the nuclear pattern with the highest antibody level is to be reported first. The advice to the clinician may be similar for the respective situations in both proposals. The lay-out of the report can be adjusted to be compatible with the local hospital information system