Published: October 2025
Medically reviewed by:
James Whitehurst, MD, PhD
Painting the full picture of diagnostics for CTD
Presented by Tara Bruner, MHS, PA-C, DFAAPA, and Amanda Aulicino, IFA Product Marketing Manager
Diagnosing connective tissue diseases (CTDs) is a complex process that can involve multiple tests. Find out how new innovations in testing can improve sensitivity and specificity, and how different platforms can complement each other for more accurate diagnoses. Watch our continuing education webinar (click on the graphic below) from Lab Week 2025 that shows how we're painting the full picture on diagnostic testing for this autoimmune disease.
Presented by:
Tara Bruner is the Manager of Clinical Education in the US with the Medical and Scientific Affairs team at Thermo Fisher Scientific. She's a practicing Physician Assistant with more than 20 years of experience and is a Distinguished Fellow of the American Academy of PAs.
Amanda Aulicino is an IFA Product Marketing Manager with Thermo Fisher Scientific. She has a wealth of knowledge on IFA and CTD testing and worked in various technical positions for more than 14 years before coming to Thermo Fisher more than a year ago.
Understanding the complexities of connective tissue disease diagnostics
Imagine a patient visits her primary care provider with vague, unexplained symptoms. She’s in her early 30s but is experiencing lots of joint pain, and not just in one joint but throughout her body. Her regular level of activity is causing her extreme fatigue. Maybe she’s had odd rashes come and go as well.
As a clinician, determining the root cause of these symptoms is like finding the proverbial needle in the haystack. You may suspect an autoimmune condition, but many of these diseases present similar symptoms. How can you more quickly identify what’s going on, or even ensure a referral to the right specialist?
When autoimmune conditions affecting connective tissues are suspected, serology must play a key role in the diagnostic process.1 That is because antinuclear antibodies (ANAs) are important for identifying particular connective tissue diseases.1 As you'll see in our Lab Week 2025 on-demand webinar, the right diagnostic tools and methods can improve testing specificity and help clinicians get to the bottom of complex diagnoses faster, which means better symptom management and quality of life for patients.
Challenges in diagnosing a connective tissue disease
As their patients’ first stop, primary care providers are used to seeing all sorts of symptoms, including vague ones that could point to many conditions. Referrals are therefore a valuable tool to help patients drill down into their symptoms, but in the case of suspected musculoskeletal or autoimmune diseases, clinicians can order additional testing to help refine the referral process and get their patients to a rheumatologist with more data in hand.
The simple fact is, there are many more patients than rheumatologists in the U.S. — about 6,000 clinically active rheumatologists are working in the U.S., so primary care providers and laboratorians can support these specialists, as well as patients, by providing serological diagnostic findings.2
Tara Bruner, MHS, PA-C, DFAAPA, said during the webinar, “We want to get patients to the specialist they need, so they can initiate treatment. We know how important this is for patients and for providers.”
How serological testing improves connective tissue disease diagnosis
When symptoms are non-specific or could be linked to numerous conditions, it’s important to test for markers in blood and tissues.1 With CTDs like systemic lupus erythematosus or Sjögren's syndrome, diagnostic markers from serological testing can help identify which CTD a patient has or if there are overlapping conditions.1,3
During the webinar, two autoimmune test methods were highlighted: immunofluorescence assay (IFAs) and solid phase assays. Both have valuable roles to play in identifying CTD markers, and there are new innovations in blood test platforms to make this testing more efficient and effective.
For example, the Helios® Automated IFA System uses computer-aided microscopy for image capturing, pattern recognition, and suggested endpoint titer. These fully enclosed systems also maintain temperature and humidity for consistent conditions regardless of the lab itself, which means better test reliability and simplified workflow for laboratorians. This helps to standardize IFA testing, which is very sensitive for detecting ANAs but not as specific as solid phase assays.3 The Helios instrument can also detect markers like double-stranded DNA and individual extractable nuclear antigens (ENAs) that are relevant to specific CTDs.
Running an IFA in conjunction with the more specific fluorescent enzyme immunoassay (FEIA), a solid phase method, can increase the clinical utility of serological testing even further. The EliA™ SymphonyS* assay tests for markers that are related to specific CTDs.1 For example, it can detect Ro 52 and Ro 60, and while additional testing would be needed to diagnosis a specific disease, these two antibodies are often associated with Sjögren's syndrome.3 This testing platform can also reduce false positives and provide a clearer picture for clinicians and patients alike.1
These testing systems complement each other by providing the sensitivity of an IFA to detect ANAs along with the specificity of a solid phase assay to home in on more precise disease correlations.
Finding answers faster for better patient care
CTDs can be challenging to diagnose, and with more patients seeking help from a limited number of rheumatologists, clinicians and laboratorians have the opportunity to improve patient outcomes with more efficient diagnoses.
By utilizing automated IFA systems in conjunction with solid phase assays, clinicians can give patients a more thorough picture of their serological profile. Rheumatologists and other specialists will also be equipped with vital patient information as soon as they see a referral. The result is a better diagnostic process for faster implementation of treatments — and that means improved symptom management and peace of mind for patients with autoimmune disorders.
*Full product name is EliA™ SymphonyS Well
