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[Paradigm shift in ANCA diagnostics : New international consensus recommendations].

E Csernok1, N Kempiners2, B Hellmich2

  • 1Referenzlabor für Vaskulitis-Immundiagnostik, Vaskulitiszentrum Süd, Klinik für Innere Medizin, Rheumatologie und Immunologie, Kreiskliniken Esslingen gGmbH, Klinik Kirchheim, Akademisches Lehrkrankenhaus der Universität Tübingen, Eugenstr. 3, 73230, Kirchheim unter Teck, Deutschland. e.csernok@kk-es.de.

Zeitschrift Fur Rheumatologie
|January 7, 2017
PubMed
Summary

New guidelines suggest antigen-specific immunoassays are superior for detecting antineutrophil cytoplasmic antibodies (ANCA) in ANCA-associated vasculitis (AAV), potentially replacing indirect immunofluorescence. This simplifies diagnosis.

Keywords:
ANCAAntigen specific ImmunoassaysConsensus recommendationVasculitis

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Area of Science:

  • Immunology
  • Clinical Diagnostics
  • Rheumatology

Background:

  • Traditional antineutrophil cytoplasmic antibodies (ANCA) detection involves indirect immunofluorescence (IIF) followed by antigen-specific assays.
  • Advancements in sensitive and specific PR3-ANCA and MPO-ANCA immunoassays question the necessity of the two-stage diagnostic approach for ANCA-associated vasculitis (AAV).

Purpose of the Study:

  • To present and discuss new international consensus recommendations for ANCA testing in AAV.
  • To provide updated guidelines for ANCA detection in clinical practice.

Main Methods:

  • Development of new ANCA testing guidelines based on a large multicenter study by the European Vasculitis Society (EUVAS).
  • The guidelines were drafted by a committee, revised by contributors, and reviewed by 12 international experts before ratification.

Main Results:

  • Results confirm the superior diagnostic value of antigen-specific immunoassays over IIF for ANCA detection.
  • The study validates the effectiveness of PR3-ANCA and MPO-ANCA immunoassays.

Conclusions:

  • Current consensus recommendations favor the primary use of PR3-ANCA and MPO-ANCA immunoassays for diagnosing AAV.
  • The findings suggest that additional IIF testing may not be categorically required for AAV diagnosis.