Abstract:
:Antibodies to neutrophil cytoplasmic antigens (ANCA) targeted toward granule enzymes have been recognized as a valuable diagnostic tool in the detection of Wegener's granulomatosis and systemic vasculitides. However, the most commonly used method of detection, the indirect immunofluorescence assay, is prone to false-positive results due to antibodies of different pathological significance either targeted to, or cross-reacting with, similarly distributed epitopes. Using double immunofluorescence, the present study demonstrates that anticytokeratin antibodies are able to produce false-positive C-ANCA immunofluorescence assays. In addition, a case of natural appearance of cytokeratin-reactive antibodies causing a false-positive "pseudo-ANCA" staining pattern in a patient presenting with sepsis is reported. Since the expression of cytokeratins is almost exclusively confined to epithelial cells, the most plausible explanation for both phenomena is a crossreaction of anticytokeratin antibodies with granule associated epitopes. Due to the natural appearance of anticytokeratin antibodies in association with a variety of other pathologic entities, it is of crucial importance for the diagnostic significance of the C-ANCA immunofluorescence assay to exclude anticytokeratin caused false-positive results. It is shown that supplementary indirect immunofluorescence tests performed on cultured human epithelial cells readily distinguish anticytokeratin caused "pseudo-ANCA" from true C-ANCA.
journal_name
J Clin Lab Analjournal_title
Journal of clinical laboratory analysisauthors
Streicher J,Fabian B,Herkner K,Pointner H,Bayer PMdoi
10.1002/(sici)1098-2825(1998)12:1<54::aid-jcla9>3.subject
Has Abstractpub_date
1998-01-01 00:00:00pages
54-9issue
1eissn
0887-8013issn
1098-2825pii
10.1002/(SICI)1098-2825(1998)12:1<54::AID-JCLA9>3.journal_volume
12pub_type
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