Antibody assessment is an essential part in the serological diagnosis of autoimmune diseases. However, different diagnostic strategies have been proposed for the work up of sera in particular from patients with systemic autoimmune rheumatic disease (SARD). In general, screening for SARD-associated antibodies by indirect immunofluorescence (IIF) is followed by confirmatory testing covering different assay techniques. Due to lacking automation, standardization, modern data management, and human bias in IIF screening, this two-stage approach has recently been challenged by multiplex techniques particularly in laboratories with high workload. However, detection of antinuclear antibodies by IIF is still recommended to be the gold standard method for antibody screening in sera from patients with suspected SARD. To address the limitations of IIF and to meet the demand for cost-efficient autoantibody screening, automated IIF methods employing novel pattern recognition algorithms for image analysis have been introduced recently. In this respect, the AKLIDES technology has been the first commercially available platform for automated interpretation of cell-based IIF testing and provides multiplexing by addressable microbead immunoassays for confirmatory testing. This paper gives an overview of recently published studies demonstrating the advantages of this new technology for SARD serology. 1. Introduction Systemic autoimmune rheumatic diseases (SARDs), such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), idiopathic inflammatory myopathies (IIM), Sj？gren’s syndrome (SjS), and antineutrophil cytoplasmic antibody (ANCA) associated systemic vasculitis (AASV), are often accompanied by the occurrence of nonorgan-specific autoantibodies (AAb) [1–4]. Especially, antinuclear antibodies (ANA) and anticytoplasmatic autoantibodies (ACyA) have been proven to be useful markers in the serological diagnosis of SARD and may also assist in the prognosis, subclassification as well as monitoring of disease activity. Indirect immunofluorescence (IIF) on HEp-2 (human epidermoid laryngeal carcinoma) cells has become the most established method for the screening of antibodies within the two-stage diagnostic strategy for SARD [4–6]. The unsurpassed high sensitivity of ANA assessment by IIF renders this method an ideal tool for the screening stage followed by confirmatory testing with different immunological assay technologies [4, 7, 8]. However, interpretation of IIF staining patterns is rather time consuming due to lacking automation and also
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