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Title: Antigen-specific ANCA ELISAs have different sensitivities for active and treated vasculitis and for nonvasculitic disease.
Austin Authors: Trevisin, Michelle;Pollock, Wendy;Dimech, Wayne;Melny, Joy;Paspaliaris, Bill;Gillis, David;Wong, Richard;Savige, Judy A
Affiliation: Division of Laboratory Medicine, Austin Hospital, Heidelberg, Australia
Issue Date: 1-Jan-2008
Publication information: American Journal of Clinical Pathology; 129(1): 42-53
Abstract: This study evaluated the performance of 12 assays for antineutrophil cytoplasmic antibodies (ANCA) directed against proteinase 3 (PR3) and myeloperoxidase (MPO) in 55 active and 68 treated cases of vasculitis and in nonvasculitic disease. It examined within- and between-assay precision; binding curves, binding levels, and interassay consistency; and sensitivity, specificity, and receiver operating characteristic analysis. All assays were highly sensitive for active vasculitis (median, 94%; range, 91%-96%), but sensitivities were more varied in treated disease (median, 69%; range, 57%-82%). Binding curves and binding levels were also very variable in PR3-ANCA and MPO-ANCA assays. This has implications for studies correlating ANCA levels with disease activity and in developing ANCA-based treatment guidelines. PR3-ANCA and MPO-ANCA assays need to be standardized as a matter of urgency, but in the meantime, individual laboratories must understand the limitations of the assays used, especially with low-level ANCA in treated vasculitis and nonvasculitic disease.
Gov't Doc #: 18089488
DOI: 10.1309/F6L4C48RHFMT4AAU
Type: Journal Article
Subjects: Antibodies, Antineutrophil Cytoplasmic.immunology
Enzyme-Linked Immunosorbent Assay.methods
Fluorescent Antibody Technique, Indirect
Granulomatosis with Polyangiitis.diagnosis.drug therapy.immunology
ROC Curve
Reproducibility of Results
Sensitivity and Specificity
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