Detection of antineutrophil cytoplasmic antibodies (ANCAs): a multicentre European Vasculitis Study Group (EUVAS) evaluation of the value of indirect immunofluorescence (IIF) versus antigen-specific immunoassays.

Abstract:

OBJECTIVE:This multicentre study was performed to evaluate the diagnostic accuracy of a wide spectrum of novel technologies nowadays available for detection of myeloperoxidase (MPO) and proteinase 3 (PR3)-antineutrophil cytoplasmic antibodies (ANCAs). METHODS:Sera (obtained at the time of diagnosis) from 251 patients with ANCA-associated vasculitis (AAV), including granulomatosis with polyangiitis and microscopic polyangiitis, and from 924 disease controls were tested for the presence of cytoplasmic pattern/perinuclear pattern and atypical ANCA (A-ANCA) by indirect immunofluorescence (IIF) (at two sites) and for the presence of PR3-ANCA and MPO-ANCA by eight different immunoassays. RESULTS:The area under the curve (AUC) of the receiver operating characteristic curve to discriminate AAV from controls was 0.923 (95% CI 0.902 to 0.944) and 0.843 (95% CI 0.814 to 0.871) for the two IIF methods. For the antigen-specific immunoassays, the AUC varied between 0.936 (95% CI 0.912 to 0.960) and 0.959 (95% CI 0.941 to 0.976), except for one immunoassay for which the AUC was 0.919 (95% CI 0.892 to 0.945). CONCLUSIONS:Our comparison of various ANCA detection methods showed (i) large variability between the two IIF methods tested and (ii) a high diagnostic performance of PR3-ANCA and MPO-ANCA by immunoassay to discriminate AAV from disease controls. Consequently, dual IIF/antigen-specific immunoassay testing of each sample is not necessary for maximal diagnostic accuracy. These results indicate that the current international consensus on ANCA testing for AAV needs revision.

journal_name

Ann Rheum Dis

authors

Damoiseaux J,Csernok E,Rasmussen N,Moosig F,van Paassen P,Baslund B,Vermeersch P,Blockmans D,Cohen Tervaert JW,Bossuyt X

doi

10.1136/annrheumdis-2016-209507

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

647-653

issue

4

eissn

0003-4967

issn

1468-2060

pii

annrheumdis-2016-209507

journal_volume

76

pub_type

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    pub_type: 杂志文章

    doi:10.1136/ard.2003.020172

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    pub_type: 杂志文章

    doi:10.1136/annrheumdis-2020-218946

    authors: Akiyama S,Hamdeh S,Micic D,Sakuraba A

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    pub_type: 杂志文章

    doi:10.1136/ard.55.7.486

    authors: Buchanan NM,Toubi E,Khamashta MA,Lima F,Kerslake S,Hughes GR

    更新日期:1996-07-01 00:00:00