Abstract
Anti-neutrophil cytoplasmic antibodies (ANCA) are a useful diagnostic tool for Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA). To maximize diagnostic utility, current guidelines recommend dual testing by standard indirect immunofluorescence (IIF) and target antigen-specific assays. Most published data come from specialized research laboratories, not reflecting the performance of assays under routine clinical conditions. Therefore, we compared the performance of standard IIF, PR3-, and MPO-ANCA-specific direct ELISA, and a PR3-ANCA-specific capture ELISA used alone and in combination under routine clinical conditions. Consecutive serum samples (615) submitted for routine ANCA testing over a 10-month period were assayed. Diagnoses were WG/MPA (n = 86), other autoimmune disease (n = 118), and various others (n = 411). The combination of PR3-ANCA and MPO-ANCA ELISA had the highest sensitivity (72.1%), and C-ANCA determination using IIF, the highest specificity (99.6%). While maintaining maximal diagnostic accuracy, significant labor savings are achieved by screening for WG/MPA by ELISA followed by confirmatory IIF.
Original language | English (US) |
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Pages (from-to) | 196-203 |
Number of pages | 8 |
Journal | Clinical Immunology |
Volume | 103 |
Issue number | 2 |
DOIs | |
State | Published - 2002 |
Keywords
- ANCA
- Autoimmune disease
- ELISA
- Microscopic polyangiitis
- Myeloperoxidase
- Proteinase 3
- Vasculitis
- Wegener's granulomatosis
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology