From the Guidelines
Annual laboratory tests are not universally recommended for monitoring autoimmune diseases, but may be necessary for certain high-risk patients or those with specific disease characteristics.
Disease-Specific Monitoring
- For patients with systemic autoimmune rheumatic diseases, such as systemic sclerosis (SSc), inflammatory myopathies (IIM), and mixed connective tissue disease (MCTD), annual screening for interstitial lung disease (ILD) may be suggested based on the presence of risk factors, such as high-risk ILD-associated antibodies (anti-synthetase and anti-MDA-5 antibodies) 1.
- In patients with autoimmune hepatitis (AIH), autoantibody titers and specificity may vary during the course of the disease, and repeated testing may allow autoantibody detection and correct disease diagnosis and classification 1.
- For children with type 1 diabetes, testing for antithyroid peroxidase and antithyroglobulin antibodies soon after diagnosis is recommended, and thyroid-stimulating hormone concentrations should be measured at diagnosis and rechecked every 1-2 years or sooner if symptoms or signs suggestive of thyroid dysfunction develop 1.
General Considerations
- The frequency of laboratory testing should be individualized based on the patient's specific disease characteristics, risk factors, and clinical course.
- A risk-based approach is preferred, taking into account the presence of high-risk autoantibodies, disease symptoms, and other factors that may affect disease activity and treatment response 1.
- Regular monitoring of autoantibody titers may not be necessary for all patients, but may be useful in certain situations, such as in pediatric patients with AIH, where autoantibody titers may correlate with disease activity 1.
From the Research
Laboratory Tests for Autoimmune Diseases
The question of whether laboratory tests should be performed annually to monitor autoimmune diseases can be addressed by considering the role of laboratory tests in the diagnosis and management of these diseases.
- Laboratory tests are essential for diagnosing and monitoring autoimmune diseases, as they can help confirm a diagnosis, estimate disease severity, and assess prognosis 2.
- Autoantibody detection and quantification are important components of laboratory testing for autoimmune diseases, and can be used to monitor disease activity and therapeutic efficacy 3, 4.
- However, not all autoantibodies are useful for monitoring disease activity, and some may not correlate with disease severity 4.
- Laboratory tests should be ordered judiciously, based on a detailed clinical review of the patient and a provisional clinical diagnosis, rather than as part of a routine "autoimmune panel" 5.
Frequency of Laboratory Tests
The frequency of laboratory tests for monitoring autoimmune diseases is not explicitly stated in the available evidence, but it can be inferred that:
- Laboratory tests should be performed as needed, based on the individual patient's clinical presentation and disease activity, rather than on a fixed annual schedule 4, 2.
- Regular monitoring of disease activity and autoantibody levels may be necessary for some patients, but the optimal frequency of testing will depend on the specific disease and patient characteristics 3, 4.