Clinical applications of antineutrophil cytoplasmic antibody testing
Purpose of review: Antineutrophil cytoplasmic antibodies are closely associated with Wegener granulomatosis, microscopic polyangiitis, and Churg-Strauss syndrome and have contributed to new pathogenetic concepts and improved nomenclature of systemic vasculitides (antineutrophil cytoplasmic antibody-...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2004
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| In: |
Current opinion in rheumatology
Year: 2004, Volume: 16, Issue: 1, Pages: 9-17 |
| ISSN: | 1531-6963 |
| DOI: | 10.1097/00002281-200401000-00004 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/00002281-200401000-00004 Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/co-rheumatology/fulltext/2004/01000/clinical_applications_of_antineutrophil.4.aspx 
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| Author Notes: | Wilhelm H. Schmitt, Fokko J. van der Woude |
| Summary: | Purpose of review: Antineutrophil cytoplasmic antibodies are closely associated with Wegener granulomatosis, microscopic polyangiitis, and Churg-Strauss syndrome and have contributed to new pathogenetic concepts and improved nomenclature of systemic vasculitides (antineutrophil cytoplasmic antibody-associated vasculitides). However, the application of antineutrophil cytoplasmic antibody testing as a clinical diagnostic tool is still regarded as controversial. This review summarizes the most recent developments in the field, identifies areas of uncertainty, and gives practical guidelines. Recent findings: The problems of antineutrophil cytoplasmic antibody testing include the diversity of antineutrophil cytoplasmic antibody target antigens, assay standardization and performance, the application of antineutrophil cytoplasmic antibody testing in a clinical setting with a low pretest probability, and, finally, the widespread assumption that antineutrophil cytoplasmic antibody titers alone may closely reflect disease activity and therefore may be used to guide therapy. Summary: Recent findings demonstrate that the combined use of indirect immunofluorescence tests and solid phase assays to detect antineutrophil cytoplasmic antibody directed against myeloperoxidase and proteinase 3 can minimize the occurrence of false-positive antineutrophil cytoplasmic antibody results. Furthermore, the yield of antineutrophil cytoplasmic antibody testing can be improved by the use of a well-standardized test, adherence to published guidelines, and restricting the use of the tests to clinical situations with a rather high pretest probability for antineutrophil cytoplasmic antibody-associated vasculitides. However, treatment decisions should be based on the clinical presentation of the patient and histologic findings and not on the results of antineutrophil cytoplasmic antibody testing alone. |
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| Item Description: | Gesehen am 02.06.2022 |
| Physical Description: | Online Resource |
| ISSN: | 1531-6963 |
| DOI: | 10.1097/00002281-200401000-00004 |