International Consensus Statement on Testing and Reporting of Antineutrophil Cytoplasmic Antibodies (ANCA)

Savige, Judy; Gillis, David; Benson, Elizabeth M.; Davies, D. J. G.; Esnault, Vincent; Falk, Ronald J.; Hagen, E. C.; Jayne, David; Jennette, J. Charles; Paspaliaris, Bill; Pollock, Wendy; Pusey, Charles D.; Savage, Caroline O. S.; Silvestrini, Roger; Woude, Fokko van der; Wieslander, Jörgen; Wiik, Allan

doi:10.1093/ajcp/111.4.507

Cited by 521 publications

(351 citation statements)

References 23 publications

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“…Therefore, it was recommended to determine ANCA by IIFT in parallel with ELISA. The strategy was also recommended by an international group to ensure optimal sensitivity and specificity (5).…”

Section: Discussionmentioning

confidence: 99%

Clinical relevance of anti‐PR3 capture ELISA in diagnosing Wegener's granulomatosis

Feng¹,

Liu²,

Li³

et al. 2008

Clinical Laboratory Analysis

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Wegener's granulomatosis (WG) is one type of systemic small vessel vasculitis and antineutrophil cytoplasmic antibodies (ANCA) have become an established diagnostic tool for systemic vasculitis. The sensitivity and specificity of anti-PR3 (proteinase 3) capture enzyme-linked immunosorbent assay (ELI-SA) in diagnosing WG were investigated, as well as the correlation with the indirect immunofluorescence test (IIFT). Sera from 72 patients with WG, 100 disease controls, and 206 healthy blood donors were investigated for anti-PR3 and cytoplasmic ANCA (cANCA) by anti-PR3 classic ELISA, anti-PR3 capture ELISA, and IIFT. The sensitivity of anti-PR3 classic ELISA and capture ELISA in diagnosing WG was 74% and 87.5% separately. The specificity of the two ELISA was identical (100%). For the combination of IIFT with anti-PR3 capture ELISA, the sensitivity for WG patients was up to 91.6%. The sensitivity of anti-PR3 capture ELISA is superior to anti-PR3 classic ELISA, and the correlation between anti-PR3 capture ELISA and IIFT is also more superior. For suspected WG, anti-PR3 capture ELISA and IIFT should be applied in parallel.

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Section: Discussionmentioning

confidence: 99%

Clinical relevance of anti‐PR3 capture ELISA in diagnosing Wegener's granulomatosis

Feng¹,

Liu²,

Li³

et al. 2008

Clinical Laboratory Analysis

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“…Although PR-3 and myeloperoxidase are the most frequent determinants, ANCA can be directed to lactoferrin, enolase, cathepsin-G, elastase, lysozyme, and other antigens (3-5, 11, 81-83). Some patients with connective tissue disorders have an atypical ANCA in which the IIF staining pattern does not resemble typical C-or P-ANCA (11,82). By IIF, P-ANCA may be identified in patients with systemic lupus erythematosus and may be difficult to distinguish from ANA (2,3,15,35,36,83).…”

Section: Discussionmentioning

confidence: 99%

“…P-ANCA can be seen in various connective tissue diseases, such as in rheumatoid arthritis, inflammatory arthritis, progressive systemic sclerosis, and other disorders (4,33,38,84). In rheumatoid arthritis, granulocyte-specific ANA can closely resemble P-ANCA in IIF tests (3,5,38,82). Finally, novel or uncharacterized antibodies could conceivably give rise to ANCA.…”

Section: Discussionmentioning

confidence: 99%

“…Interpretative and reproducibility issues may occur in the evaluation of sera by the IIF method (33,82,83). There may be considerable interinstitutional variation in performing ANCA (4, 9, 85).…”

Section: Discussionmentioning

confidence: 99%

“…For example, a small focus of vasculitis or capillaritis could be overlooked when another pattern predominates. Although many hospital laboratories only perform IIF testing, it is highly recommended that a positive ANCA result be followed by an ELISA for PR-3 and/or myeloperoxidase (3,5,11,14,33,82,83,86,88). The pathologist should inquire as to what type of ANCA test was performed (IIF versus ELISA), where it was performed (hospital versus reference versus research laboratory), and whether multiple autoantibodies (antinuclear antibodies, rheumatoid factor, antiglomerular basement membrane (79) Anticytokeratins (80) antibody, or others) are present.…”

Section: Discussionmentioning

confidence: 99%

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Antineutrophil Cytoplasmic Autoantibody in the Absence of Wegener's Granulomatosis or Microscopic Polyangiitis: Implications for the Surgical Pathologist

Gal

Velasquez

2002

Modern Pathology

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Antineutrophil cytoplasmic antibodies (ANCA) are useful serologic markers for the diagnosis and management of patients with Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA). However, problems in diagnosis and classification may occur when patients with other disorders develop ANCA. A 7-year review (1993-1999) disclosed 247 patients whose sera tested positively for ANCA by an indirect immunofluorescence method: 166 patients for cytoplasmic-ANCA (C-ANCA) and 81 patients for perinuclear-ANCA (P-ANCA) Twenty-seven patients had active pulmonary disease and underwent openlung biopsy or transbronchial biopsy. Eight patients (30%) had a disease other than WG or MPA, and their clinical, pathological, and serological findings were reviewed. The patients, all women, ranged in age from 28 to 77 years (median, 37 y). Dyspnea (n ‫؍‬ 6), cough (n ‫؍‬ 6), chest pain (n ‫؍‬ 2), and/or hemoptysis (n ‫؍‬ 2) were present. The duration of symptoms lasted from 3 weeks to 6 years (median, 6 mo). ANCA titers were C-ANCA (n ‫؍‬ 4; range, 1:40 -1280) or P-ANCA (n ‫؍‬ 4; range, 1:40 -640). The lung biopsies disclosed nonspecific interstitial pneumonia (n ‫؍‬ 4), bronchiolitis obliterans organizing pneumonia (n ‫؍‬ 1), diffuse alveolar damage (n ‫؍‬ 1), organizing diffuse alveolar hemorrhage without capillaritis (n ‫؍‬ 1), and necrotic granuloma (n ‫؍‬ 1). No cases showed characteristic histology for WG or MPA. The final diagnoses were various connective tissue disorders (n ‫؍‬ 5), chronic hypersensitivity pneumonia (n ‫؍‬ 1), postinfectious bronchitis/bronchiectasis (n ‫؍‬ 1), and ulcerative colitis-related lung disease (n ‫؍‬ 1). Surgical pathologists should be aware that significantly elevated ANCA titers may be associated with diverse forms of pulmonary disease. ANCA positivity alone, in the absence of appropriate clinical or pathologic findings, should not be used to substantiate a diagnosis of WG or MPA.

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Using Antineutrophil Cytoplasmic Antibody Testing to Diagnose Vasculitis

Mandl¹,

Solomon²,

Smith³

et al. 2002

Arch Intern Med

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International Consensus Statement on Testing and Reporting of Antineutrophil Cytoplasmic Antibodies (ANCA)

Abstract: A b s t r a c tAntineutrophil cytoplasmic antibody (ANCA)

Cited by 521 publications

References 23 publications

Clinical relevance of anti‐PR3 capture ELISA in diagnosing Wegener's granulomatosis

Clinical relevance of anti‐PR3 capture ELISA in diagnosing Wegener's granulomatosis

Antineutrophil Cytoplasmic Autoantibody in the Absence of Wegener's Granulomatosis or Microscopic Polyangiitis: Implications for the Surgical Pathologist

Using Antineutrophil Cytoplasmic Antibody Testing to Diagnose Vasculitis

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