Page 177 - The Vasculitides, Volume 1: General Considerations and Systemic Vasculitis

In: The Vasculitides, Volume 1 ISBN: 978-1-63463-110-5
Editors: David S. Younger © 2015 Nova Science Publishers, Inc.

Chapter 8

Detection Techniques and Clinical
Relevance of ANCA Testing in
ANCA-Associated Vasculitis

Elena Csernok, Ph.D.?

Department of Rheumatology, University of Schleswig-Holstein, Germany

Abstract

Antineutrophil cytoplasmic antibodies (ANCA) testing is an established diagnostic
tool in the necrotizing vasculitides and their presence define ANCA-associated
vasculitides (AAV). They are also detected in a wide range of inflammatory and
infectious diseases leading to a critical reappraisal in the diagnostic significance. The
diagnostic utility of ANCA depends on type of assay performed and the clinical setting.
Methods of ANCA detection have been standardized in large multicenter studies.

An international consensus statement on testing and reporting on ANCA has been
published. ANCA are detected by indirect immunofluorescence technique (IFT) on
human neutrophils. PR3- and MPO-ANCA specificity is determined by antigen-specific
immunometric assays. Novel methods for PR3- and MPO-ANCA detection have been
developed to improve the performance of traditional ANCA-specific assays.

The remaining challenges in routine clinical practice include the methodological
aspects of test performance by immunofluorescence and the diversity of antigen-specific
assays, the application of testing in clinical settings with low pretest probability, and the
value of serial testing in the prediction of disease relapse.

Keywords: ANCA, proteinase 3, myeloperoxidase, ANCA-associated vasculitides

? Corresponding author: Elena Csernok. Department of Rheumatology, University of Schleswig-Holstein, Campus
Luebeck and Klinikum Bad Bramstedt, Oskar-Alexanderstr. 26, 24576 Bad Bramstedt. Phone: 49
4192902195, e-mail: [email protected], fax: 49 4192902381.

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