The diagnostic value of anti-neutrophil cytoplasmic antibody testing in a routine clinical setting.
Anti-neutrophil cytoplasmic antibody (ANCA) tests are a routine clinical assay in most UK hospitals. We examined the role of routine ANCA testing in achieving a diagnosis of systemic vasculitis in a routine clinical setting. From April 1996 to March 2000, 2734 samples from five hospital departments...
| Principais autores: | , , , , |
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| Formato: | Journal article |
| Idioma: | English |
| Publicado em: |
2001
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| _version_ | 1826296310062383104 |
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| author | McLaren, J Stimson, R McRorie, E Coia, J Luqmani, R |
| author_facet | McLaren, J Stimson, R McRorie, E Coia, J Luqmani, R |
| author_sort | McLaren, J |
| collection | OXFORD |
| description | Anti-neutrophil cytoplasmic antibody (ANCA) tests are a routine clinical assay in most UK hospitals. We examined the role of routine ANCA testing in achieving a diagnosis of systemic vasculitis in a routine clinical setting. From April 1996 to March 2000, 2734 samples from five hospital departments were tested for ANCA by indirect immunofluorescence (IIF) at a single laboratory. After April 1999, enzyme-linked immunosorbent assays (ELISAs) were performed on all IIF-positive samples. Clinical diagnosis was determined for all patients with a positive IIF ANCA, and a sample of the ANCA-negative patients. Some 2-18% of patients with suspected ANCA-associated systemic vasculitis (AASV) had positive IIF ANCA. The AASV diagnosis was confirmed in 0-56% of these cases. Analysis by department suggested that 88-100% of patients with a positive IIF ANCA did not have AASV, except in the Rheumatology department. The positive predictive value (PPV) of IIF ANCA for AASV was 59% and the negative predictive value (NPV) was 84%. Of the patients with proven AASV, 41% did not have ANCA on IIF. Combined ANCA testing by IIF/ELISA had a higher sensitivity and PPV but lower specificity than IIF alone for AASV. For the combined IIF/ELISA test, only the Rheumatology department had a sensitivity or PPV >0% for AASV. The PPV of ANCA by IIF/ELISA for AASV was 79% and the NPV was 63%. The ANCA test is being widely applied with very poor return. Guidelines for more effective usage are proposed. |
| first_indexed | 2024-03-07T04:14:22Z |
| format | Journal article |
| id | oxford-uuid:c8ea31fb-e549-42c7-9dd0-cc62183c4a0a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:14:22Z |
| publishDate | 2001 |
| record_format | dspace |
| spelling | oxford-uuid:c8ea31fb-e549-42c7-9dd0-cc62183c4a0a2022-03-27T06:55:20ZThe diagnostic value of anti-neutrophil cytoplasmic antibody testing in a routine clinical setting.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c8ea31fb-e549-42c7-9dd0-cc62183c4a0aEnglishSymplectic Elements at Oxford2001McLaren, JStimson, RMcRorie, ECoia, JLuqmani, RAnti-neutrophil cytoplasmic antibody (ANCA) tests are a routine clinical assay in most UK hospitals. We examined the role of routine ANCA testing in achieving a diagnosis of systemic vasculitis in a routine clinical setting. From April 1996 to March 2000, 2734 samples from five hospital departments were tested for ANCA by indirect immunofluorescence (IIF) at a single laboratory. After April 1999, enzyme-linked immunosorbent assays (ELISAs) were performed on all IIF-positive samples. Clinical diagnosis was determined for all patients with a positive IIF ANCA, and a sample of the ANCA-negative patients. Some 2-18% of patients with suspected ANCA-associated systemic vasculitis (AASV) had positive IIF ANCA. The AASV diagnosis was confirmed in 0-56% of these cases. Analysis by department suggested that 88-100% of patients with a positive IIF ANCA did not have AASV, except in the Rheumatology department. The positive predictive value (PPV) of IIF ANCA for AASV was 59% and the negative predictive value (NPV) was 84%. Of the patients with proven AASV, 41% did not have ANCA on IIF. Combined ANCA testing by IIF/ELISA had a higher sensitivity and PPV but lower specificity than IIF alone for AASV. For the combined IIF/ELISA test, only the Rheumatology department had a sensitivity or PPV >0% for AASV. The PPV of ANCA by IIF/ELISA for AASV was 79% and the NPV was 63%. The ANCA test is being widely applied with very poor return. Guidelines for more effective usage are proposed. |
| spellingShingle | McLaren, J Stimson, R McRorie, E Coia, J Luqmani, R The diagnostic value of anti-neutrophil cytoplasmic antibody testing in a routine clinical setting. |
| title | The diagnostic value of anti-neutrophil cytoplasmic antibody testing in a routine clinical setting. |
| title_full | The diagnostic value of anti-neutrophil cytoplasmic antibody testing in a routine clinical setting. |
| title_fullStr | The diagnostic value of anti-neutrophil cytoplasmic antibody testing in a routine clinical setting. |
| title_full_unstemmed | The diagnostic value of anti-neutrophil cytoplasmic antibody testing in a routine clinical setting. |
| title_short | The diagnostic value of anti-neutrophil cytoplasmic antibody testing in a routine clinical setting. |
| title_sort | diagnostic value of anti neutrophil cytoplasmic antibody testing in a routine clinical setting |
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