Performance of two strategies for urgent ANCA and anti-GBM analysis in vasculitis

Anoek A. E. de Joode*, Caroline Roozendaal, Marcel J. van der Leij, Laura B. Bungener, Jan Stephan Sanders, Coen A. Stegeman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

16 Citations (Scopus)

Abstract

Background: In anti-neutrophil cytoplasmic antibodies (ANCA) associated small vessel vasculitis (AAV), rapid testing for ANCA and anti-glomerular basement membrane (GBM) antibodies may be beneficial for therapeutic purpose.

Objective: We analysed the diagnostic performance of two rapid ANCA and anti-GBM test methods in 260 patients with suspected AAV.

Methods: Between January 2004 and November 2010, we analysed 260 samples by qualitative Dotblot (Biomedical Diagnostics); retrospective analysis followed with directly coated highly sensitive automated Phadia ELiA and ELiA anti-GBM.

Results were related to the final clinical diagnosis and compared with routine capture ELISA.

Results: Seventy-four patients had a final diagnosis of AAV (n = 62) or anti-GBM disease (n = 12). Both Dotblot and ELiA detected all 12 cases of anti-GBM disease; 2 false positive results were found. Dotblot detected ANCA in 56 of 62 AAV patients (sensitivity 90%, NPV 97%), and showed 5 false positives (specificity 97%, PPV 90%). The Phadia ELiA anti-PR3(s) or anti-MPOs was positive in 57 of 62 AAV patients (sensitivity 92%, NPV 97%), and had 5 false positives (specificity 97%, PPV 88%). Routine capture ELISA was equally accurate (sensitivity 94%, specificity 97%, PPV 88%, NPV 98%).

Conclusion: The Dotblot and Phadia ELiA on anti-GBM, anti-PR3(s) and anti-MPOs performed excellently; results were almost identical to routine ELISA. When suspicion of AAV or anti-GBM disease is high and diagnosis is urgently needed, both tests are very powerful for rapid serological diagnosis. Further studies have to confirm the test performances in samples routinely presented for ANCA testing and in follow-up of positive patients. (C) 2013 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)182-186
Number of pages5
JournalEuropean Journal of Internal Medicine
Volume25
Issue number2
DOIs
Publication statusPublished - Feb-2014

Keywords

  • Serology
  • Systemic vasculitis
  • Dotblot
  • ELiA
  • ELISA
  • Indirect immunofluorescence
  • ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES
  • INTERNATIONAL CONSENSUS STATEMENT
  • SMALL-VESSEL VASCULITIS
  • WEGENERS-GRANULOMATOSIS
  • CRESCENTIC GLOMERULONEPHRITIS
  • MYELOPEROXIDASE
  • AUTOANTIBODIES
  • PROTEINASE-3
  • DISEASES

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