Antineutrophil cytoplasmic antibodies: appropriate use and interpretation

• Published in: Annals of the rheumatic diseases Vol. 76; no. 8; p. e24
• Main Authors: Damoiseaux, Jan, Csernok, Elena, Rasmussen, Niels, Cohen Tervaert, Jan-Willem, Bossuyt, Xavier
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.08.2017
• Subjects: Antibodies; Antibodies, Antineutrophil Cytoplasmic; Antigens; Antineutrophil cytoplasmic antibodies; Disease; Endocarditis; Fluorescent Antibody Technique, Indirect; Granulomatosis with Polyangiitis; Hepatitis; Humans; Immunoassay; Immunoglobulins; Inflammatory bowel disease; Autoimmunity; Systemic vasculitis; Autoantibodies
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2016-210908

[...]ANCA help with the diagnostic workup of AAV and should be interpreted together with clinical and histological data. [...]drugs, such as hydralazine, propylthiouracil and levamisole-adulterated cocaine, can induce secondary forms of AAV. 6 Based on associations with genetic background and epidemiology, it has been suggested that ANCA specificity (PR3-ANCA vs MPO-ANCA) could be better than clinicopathological diagnosis (GPA, MPA) for defining homogeneous groups of patients. 7 8 We agree with Novikov et al 1 that this discussion cannot be finalised yet. In some gastrointestinal disorders such as ulcerative colitis, autoimmune hepatitis and primary sclerosing cholangitis, atypical ANCA can be detected by IIF. 9 10 As the target antigen is not known, specific immunoassays are not available. [...]Novikov et al 1 addressed some important points related to correct ANCA use and interpretation. Detection of antineutrophil cytoplasmic antibodies (ANCAs): a multicentre European Vasculitis Study Group (EUVAS) evaluation of the value of indirect...