Details

Autor(en) / Beteiligte

• Guchelaar, Niels A.D.
• Waling, Manon M.
• Adhin, Anviti A.
• van Daele, Paul L.A.
• Schreurs, Marco W.J.
• Rombach, Saskia M.

Titel

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

Ist Teil von

• Autoimmunity reviews, 2021-01, Vol.20 (1), p.102716, Article 102716

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• 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. •ANCA testing is commonly used when an ANCA-associated vasculitis is suspected.•The specificity of all ANCA tests is high, with variable sensitivities.•Primary screening for AAV is advised with anti-PR3 and anti-MPO immunoassay.•A negative test result for anti-PR3 or anti-MPO does not exclude an AAV.