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Showing 2 results for Sheikh Sajjadieh
Estimation of sensitivity and specificity of antinuclear antibody by automated indirect immunofluorescence and enzyme-linked immunoassay
Mohammadreza Sheikh Sajjadieh , Ali Ajami , Leila Haghshenas ,
Volume 18, Issue 4 (Jul-Aug 2024)
Abstract
Background: Immunofluorescence and serology analysis are the most common laboratory methods for diagnosing antinuclear antibodies in autoimmune diseases and are paramount for screening and therapeutic purposes. This study aims to estimate the sensitivity and specificity of antinuclear antibodies measured by automated indirect immunofluorescence and enzyme-linked immunoassay in patients at risk for autoimmune diseases.
Methods: Serum antinuclear antibodies in 3020 patients suspected of autoimmune diseases at Nobel Medical Laboratory, Esfahan, IRAN, were measured from 2017 until 2020 with automated indirect immunofluorescence and enzyme-linked immune assay methods. The sensitivity, specificity, prevalence, positive and negative predictive value, and likelihood ratio were calculated for each technique. In addition, the receiver operating characteristic curve (ROC) was analysed as a statistical method for assessing the diagnostic accuracy of these tests.
Results: The immunofluorescence method demonstrated low sensitivity and high specificity compared with the enzyme-linked immunoassay. For the automated indirect immunofluorescence method, sensitivity and specificity were 88% and 62%, respectively, whereas this number for the ELISA method was determined as 89.6% and 28.5 %, respectively.
Conclusion: It is crucial to choose a suitable method for detecting autoantibodies for diagnostic purposes. ANA analysis by a sensitive test, such as an enzyme-linked immunoassay, should be used for screening. In contrast, a highly specific test, such as an indirect immunofluorescence assay, should be used to confirm the result and monitor dynamic treatment.
 

Diagnostic value of polarized optical microscopy in pseudogout: A review of calcium pyrophosphate deposition disease in the clinical laboratory
Mohammadreza Sheikh Sajjadieh,
Volume 19, Issue 6 (Nov-Dec 2025)
Abstract
Background: Pseudogout, also known as calcium pyrophosphate deposition (CPPD) disease, is a common but often underdiagnosed crystal-induced arthropathy. It occurs when CPPD crystals deposit in articular cartilage and synovial fluid. Because its clinical manifestations often mimic gout or septic arthritis, accurate differentiation is essential for appropriate patient management. Recognition of the unique pathophysiology and crystal morphology of pseudogout is therefore critical for laboratory diagnosis.
Methods: This narrative review summarizes and integrates findings from selected, well-established sources to provide clinical and laboratory perspectives, highlight best practices, and identify areas requiring standardization. The existing evidence regarding the diagnostic application of polarized optical microscopy (POM) in pseudogout was evaluated. Key themes include the principles of POM, optimal specimen collection and handling, techniques for accurate crystal identification, and recommended laboratory workflow practices. Additionally, the review discusses factors that influence diagnostic accuracy, such as technician proficiency and the use of standardized microscopic evaluation protocols.
Results: The findings indicate that polarized light microscopy remains the gold standard for identifying CPPD crystals. Rhomboid-shaped crystals exhibiting weakly positive birefringence are characteristic of pseudogout and allow reliable differentiation from monosodium urate crystals observed in gout. Proper specimen preparation - particularly timely examination of fresh synovial fluid - and adherence to standardized microscopy practices significantly enhance diagnostic yield. In addition, targeted technician training in crystal recognition improves interobserver consistency and reduces misclassification.
Conclusion: Polarized light microscopy is an indispensable tool for the accurate laboratory diagnosis of pseudogout. Increasing awareness of crystal morphology, improving specimen-handling practices, and investing in consistent technician training can substantially enhance diagnostic accuracy. Standardizing the use of POM across clinical laboratories will support earlier detection and improved clinical management of pseudogout.

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