The value of anti-neutrophil cytoplasmic antibodies (ANCA) testing for the diagnosis of ANCA-associated vasculitis, a systematic review and meta-analysis.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101128967 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-0183 (Electronic) Linking ISSN: 15689972 NLM ISO Abbreviation: Autoimmun Rev Subsets: MEDLINE
    • Publication Information:
      Original Publication: Amsterdam ; New York : Elsevier, c2002-
    • Subject Terms:
      Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis*/diagnosis ; Antibodies, Antineutrophil Cytoplasmic*; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoassay ; Myeloblastin ; Peroxidase
    • Abstract:
      The testing of anti-neutrophil cytoplasmic antibodies (ANCA) takes an important place in the diagnostic workup to ANCA-associated vasculitis (AAV). Nowadays, it is recommended to screen for the presence of PR3 and MPO specific antibodies first using immunoassay, without the need for ANCA measurement by indirect immunofluorescence (IIF). A literature search was performed to assess the diagnostic test value of ANCA IIF and PR3- and MPO-antibody immunoassay to diagnose AAV. This meta-analysis shows that the c-ANCA testing by IIF has a pooled sensitivity of 75.2% and a pooled specificity of 98.4%. For PR3-antibody immunoassay, the pooled sensitivity depended on the immunoassay method used, and ranged from 79.8% to 86.6%, whereas the pooled specificity ranged from 96.8% to 98.3%. For both p-ANCA IIF and MPO-antibody immunoassay (all methods) sensitivity varied considerably showing pooled values of respectively 46.3% and 58.1%, whereas respective pooled specificity was 91.4% and 95.6%. These findings support the 2017 international consensus that primary anti-PR3 and anti-MPO screening by immunoassay, based on superior immunoassay sensitivity without the need for IIF ANCA testing, improves the diagnostic workup of AAV.
      (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Keywords: ANCA-associated vasculitis; Anti-neutrophil cytoplasmic antibodies; Diagnostic test; Immunoassay; Indirect immunofluorescence; Sensitivity and specificity
    • Accession Number:
      0 (Antibodies, Antineutrophil Cytoplasmic)
      EC 1.11.1.7 (Peroxidase)
      EC 3.4.21.76 (Myeloblastin)
    • Publication Date:
      Date Created: 20201116 Date Completed: 20210125 Latest Revision: 20210125
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.autrev.2020.102716
    • Accession Number:
      33197574