Determination of anti-neutrophil cytoplasmic antibodies in small vessel vasculitis: Comparative analysis of different strategies

Clinica Chimica Acta; International Journal of Clinical Chemistry
Pieter VermeerschXavier Bossuyt

Abstract

Anti-neutrophil cytoplasmic antibodies (ANCA) are associated with primary small vessel vasculitis (SVV). Proteinase-3 (PR3)-ANCA are primarily associated with Wegener granulomatosis, whereas myeloperoxidase (MPO)-ANCA are primarily associated with microscopic polyangiitis (MPA) and vasculitic Churg-Strauss syndrome. We evaluated whether a strategy that is based on screening with ELISA or fluoroenzymeimmunoassay (FEIA) is an accurate alternative to screening with indirect immunofluorescence (IIF). C-ANCA and P-ANCA were determined by IIF and PR3-ANCA and MPO-ANCA were determined by ELISA (Inova) or FEIA (Phadia) on 326 patients (38 with newly diagnosed SVV and 288 diseased controls). Specificity and positive likelihood ratios were higher for ELISA and FEIA than for IIF. Post-test probability for SVV of a positive test result was higher for ELISA and FEIA than for IIF. Decision tree analysis in which several testing strategies were compared revealed that a testing strategy that is based on screening with ELISA or FEIA had an expected clinical utility that was comparable to screening with IIF and confirming with ELISA or FEIA. The highest expected clinical utility was found when both IIF and ELISA or FEIA were performed on all sam...Continue Reading

Citations

Jan 24, 2012·Clinica Chimica Acta; International Journal of Clinical Chemistry·M MahlerR A Sinico
Jun 4, 2014·Nature Reviews. Rheumatology·Elena Csernok, Frank Moosig
Jun 21, 2011·Autoimmune Diseases·Konstantinos TsiveriotisChryssa Papasteriades
Nov 20, 2009·Current Rheumatology Reports·Luis Felipe Flores-Suárez
Dec 24, 2013·European Journal of Internal Medicine·Anoek A E de JoodeCoen A Stegeman
Jul 6, 2014·Journal of Immunology Research·Johannes Schulte-PelkumMichael Mahler
Jun 26, 2017·Auto- Immunity Highlights·Luigi CinquantaNicola Bizzaro
Mar 10, 2017·Annals of the Rheumatic Diseases·Jan DamoiseauxXavier Bossuyt
Jan 7, 2017·Zeitschrift für Rheumatologie·E CsernokB Hellmich
Jul 16, 2017·Clinical Chemistry and Laboratory Medicine : CCLM·Jan DamoiseauxYehuda Shoenfeld
Nov 26, 2009·Current Opinion in Rheumatology

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