Appropriateness of test request and clinical outcome: the case of autoimmune diseases

Objectives: To improve the appropriateness in the autoantibody test requests for proper diagnosis of systemic rheumatic autoimmune diseases, celiac disease and anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides. Methodology: Review of recommendations proposed by the Study Group in Autoimmunology (GDS-AI) of the Italian Society of Clinical Pathology and Laboratory Medicine (SIPMeL) and the European Society For Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHaN) Results: This document aims to bring to the attention of general practitioners the recommendations proposed by National and International study group to improve the appropriateness in the autoantibody test requests expecially in sytemic autoimmune and celiac disease. Conclusions: Autoimmunity is a specialistic laboratory area where the costs are extremely high compared to other diagnostics: it would therefore be very helpful and economically advantageous to align the clinicians on appropriate requests and the laboratory on useful diagnostics. In Autoimmunology, diagnostic appropriateness remains a complex and debated topic from the management, professional and economic point of view.