2a) Our expert author is Pankti Mehta @PanktiMehta24, MBBS, MD Med, Asst Prof @KGMUindia, Lucknow | Clinical #Immunology & #Rheumatology @SGPGI | DSMC member @rheumjnl @IJRheum @IndianRheum| @KEMhospital, Mumbai 🇮🇳 pic.twitter.com/4pUzXMveIW
— @rheum_ce (@rheum_ce) May 25, 2023
3) So . . . Antinuclear Antibodies (#ANA)
Let's talk about a #rheumatology test that can confuse > help if ordered without a 💭
Let's take a peek 🔍 into the #immunology lab to learn more about the lab aspect of ANA 🥼🧪 pic.twitter.com/wFm0h8QSr4— @rheum_ce (@rheum_ce) May 25, 2023
5a) Which one of the following is the oldest test to detect #ANA? 📜
— @rheum_ce (@rheum_ce) May 25, 2023
6) 🤷How do we test for LE cells?
First, 💉🩸
Then, shake 🪩 vigorously for #leukocytes to rupture & release nuclear material
Then, incubate for #ANAs to bind to this material & #phagocytes to eat🍴 these up
Finally, centrifuge ➡️ #buffycoat ➡️stain ➡️🔬 pic.twitter.com/ePaRqUrs1A— @rheum_ce (@rheum_ce) May 25, 2023
8) 🤷What do we mean by #IFA??
1⃣ #Hep2 cells are fixed on a slide
🧐Why hep2 cells? Large nuclei + presence of dividing cells➡️easier to✅for #ANA🔬
2⃣ add serum in appropriate dilution (remember pro/post zone phenomena!)
3⃣ #ANA, if present, will bind to Hep2 cells pic.twitter.com/wrxbgsaxbe— @rheum_ce (@rheum_ce) May 25, 2023
10) #IFA tells you 3️⃣things:
👉Titre: the dilution at which #ANA is positive, usually done in 1:80 or 1:100
👉Intensity of staining
👉Pattern: a specific staining pattern helps identify the type of #antigen (BTW: it's like fireflies on a slide!) pic.twitter.com/7bjuVJqnWe— @rheum_ce (@rheum_ce) May 25, 2023
13) What about #ELISA?
👉A mix of nuclear Ag coated on a plate
👉Hep2 extract: 👍sensitivity, 👎specificity
👉Mix of separate Ag: 👎sensitivity, 👍specificity
Why?
🔹Different Ag may compete for binding 🍽️
🔹3D structure of Ag may change
Specific Ag can't be determined pic.twitter.com/ojpSkOJHj7— @rheum_ce (@rheum_ce) May 25, 2023
15) And you just earned 0.25hr 🆓CE/#CME! Claim your certificate at https://t.co/MblJ7v9K21.
FOLLOW US for more #MedEd in #rheumatology, delivered wholly on Twitter!@PanktiMehta24 and @academiccme thank you for joining us!!— @rheum_ce (@rheum_ce) May 25, 2023
