Antineutrophil cytoplasmic antibodies: reporting and diagnostic strategies

Damoiseaux, Jan; Csernok, Elena; Rasmussen, Niels; Tervaert, Jan-Willem Cohen; Bossuyt, Xavier

doi:10.1136/annrheumdis-2017-211171

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…These results indicated that the 1999 international consensus on ANCA testing for AAV needed revision [7][8][9][10] .…”

Section: Rationale For a New Consensusmentioning

confidence: 65%

“…False-positive results do occur with immunoassays, mainly in samples with a low degree of positivity 78 . Therefore, performing a second assay or IIF can marginally increase the specificity in cases of low-positive test results 10 . When new assays are introduced (including assays not included in the EUVAS study 6 ), the diagnostic performance of such assays should be checked based on samples from patients with GPA or MPA and relevant disease controls.…”

Section: Post-test Probabilitymentioning

confidence: 99%

“…Given the improvements in antigen-specific immuno assays, the international consensus on the testing of ANCAs in small-vessel vasculitis seems in need of updating [7][8][9][10] . In this manuscript, a revised 2017 international consensus is proposed by a group of international experts (from North and Central America, Australia, Europe and Asia) in the ANCA field.…”

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confidence: 99%

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Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis

et al. 2017

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| Anti-neutrophil cytoplasmic antibodies (ANCAs) are valuable laboratory markers used for the diagnosis of well-defined types of small-vessel vasculitis, including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). According to the 1999 international consensus on ANCA testing, indirect immunofluorescence (IIF) should be used to screen for ANCAs, and samples containing ANCAs should then be tested by immunoassays for proteinase 3 (PR3)-ANCAs and myeloperoxidase (MPO)-ANCAs. The distinction between PR3-ANCAs and MPO-ANCAs has important clinical and pathogenic implications. As dependable immunoassays for PR3-ANCAs and MPO-ANCAs have become broadly available, there is increasing international agreement that high-quality immunoassays are the preferred screening method for the diagnosis of ANCA-associated vasculitis. The present Consensus Statement proposes that high-quality immunoassays can be used as the primary screening method for patients suspected of having the ANCA-associated vaculitides GPA and MPA without the categorical need for IIF, and presents and discusses evidence to support this recommendation.NATURE REVIEWS | RHEUMATOLOGY VOLUME 13 | NOVEMBER 2017 | 683 CONSENSUS STATEMENT © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .Given the improvements in antigen-specific immuno assays, the international consensus on the testing of ANCAs in small-vessel vasculitis seems in need of updating [7][8][9][10] . In this manuscript, a revised 2017 international consensus is proposed by a group of international experts (from North and Central America, Australia, Europe and Asia) in the ANCA field. This Consensus Statement highlights the value of ANCA testing as a tool for diagnosis (but not follow-up) of GPA and MPA and gives a historical perspective of ANCAs in small-vessel vasculitis. This Consensus Statement does not, however, present evidence-based guidelines or a meta-analysis. MethodsThis Consensus Statement was prepared by a group of experts from four European laboratories (X.B., J.D., N.R., J.W.C.T. and E.C.) in person and by correspondence. The draft was circulated to each contributor and modified, and the resulting document was distributed by e-mail to 16 experts from four continents, selected based on their expertise and knowledge in clinical and/or laboratory aspects of AAV. This revised document resulted in a second round of discussions and revisions. The final document was returned to all contributors for ratification.The Consensus Statement is based on the results of a multicentre European Vasculitis Study Group (EUVAS) evaluation of the value of IIF versus antigen-specific immunoassays for ANCA detection 6,11,12 . This study, which showed a large variability between different IIF methods and a good diagnostic performance of PR3-ANCA and MPO-ANCA immunoassays 6 , indicated that the 1999 international consensus on ANCA testing for AAV needed revision. When the consensus was put toget...

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“…These results indicated that the 1999 international consensus on ANCA testing for AAV needed revision [7][8][9][10] .…”

Section: Rationale For a New Consensusmentioning

confidence: 65%

Section: Post-test Probabilitymentioning

confidence: 99%

mentioning

confidence: 99%

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Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis

et al. 2017

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“…ANA reports should be done according to ICAP recommendations [ 16 ], at least using the nomenclature. Depending on the clinical pre-test probability, there are good arguments to report specific likelihood ratios [ 46 , 47 ] in addition to titers.…”

Section: Results Reportingmentioning

confidence: 99%

Quality and best practice in medical laboratories: specific requests for autoimmunity testing

Sack

Bossuyt

Andreeva

et al. 2020

Autoimmun Highlights

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Special conditions associated with laboratory autoimmune testing are not well compatible with recent developments in regulatory frameworks such as EN/ISO 15189 accreditation or in vitro diagnostic medical device regulation (IVD-R). In addition, international recommendations, guidelines and disease criteria are poorly defined with respect to requirements on autoantibody testing. Laboratory specialists from Austria,

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“…We read with great interest the multicentre study of Damoiseaux et al [1][2][3] on the detection of antineutrophil cytoplasmic antibodies (ANCA). ANCAs are important laboratory markers to support the diagnosis of ANCA-associated small vessel vasculitis (AAV), including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA).…”

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confidence: 99%

Revised 2017 international consensus on ANCA testing in small vessel vasculitis: support from an external quality assessment

et al. 2018

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Antineutrophil cytoplasmic antibodies: reporting and diagnostic strategies

Cited by 7 publications

References 14 publications

Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis

Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis

Quality and best practice in medical laboratories: specific requests for autoimmunity testing

Revised 2017 international consensus on ANCA testing in small vessel vasculitis: support from an external quality assessment

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