Detection of anti-neutrophil cytoplasmic antibodies under actual clinical testing conditions

被引:62
作者
Russell, KA
Wiegert, E
Schroeder, DR
Homburger, HA
Specks, U
机构
[1] Mayo Clin & Mayo Fdn, Div Pulm & Crit Care Med, Rochester, MN 55905 USA
[2] Mayo Clin & Mayo Fdn, Div Immunol, Rochester, MN 55905 USA
[3] Mayo Clin & Mayo Fdn, Biostat Sect, Rochester, MN 55905 USA
关键词
Wegener's granulomatosis; microscopic polyangiitis; vasculitis; proteinase; 3; myeloperoxidase; autoimmune disease; ELISA;
D O I
10.1006/clim.2001.5200
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
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. (C) 2002 Elsevier Science (USA).
引用
收藏
页码:196 / 203
页数:8
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