Niels A. Guchelaar, Netherlands

Erasmus University Medical Center, Rotterdam RG5
I'm Niels Guchelaar, a Dutch medical student. During my study in medicine, I've performed research at the department of immunology at the Erasmus University Medial Center, Rotterdam. I will start with my PhD at the oncology department this September.

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THE VALUE OF ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODIES (ANCA) TESTING FOR THE DIAGNOSIS OF ANCA-ASSOCIATED VASCULITIS, A SYSTEMATIC REVIEW AND META-ANALYSIS

Session Name
PS40 - NOVELTIES IN VASCULITIDES
Session Type
PARALLEL SESSIONS
Date
31.05.2021, Monday
Session Time
10:00 - 12:00
Room
HALL A
Lecture Time
11:30 - 11:40
Presenter
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Abstract

Background and Aims

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).

Methods

A literature search was performed to assess the diagnostic test value of ANCA IIF and PR3- and MPO-antibody immunoassay to diagnose AAV.

Results

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 is 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%.

Conclusions

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

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