ANCA Diagnostics in Clinical Practice: New Developments

Damoiseaux, Jan; Austen, Jos; Tervaert, Jan Willem Cohen

doi:10.5772/21837

Cited by 1 publication

(1 citation statement)

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“…Like in ANA detection [ 12 ], the immunofluorescence pattern of ANCA has predictive value for the antigen specificity of the ANCA [ 13 ]. The international consensus prescribes that, whatever the ANCA pattern, testing for both MPO- and PR3-ANCA should be performed [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Automatic Reading of ANCA-Slides: Evaluation of the AKLIDES System

Damoiseaux

Mallet

Vaessen

et al. 2012

Clinical and Developmental Immunology

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The ANCA consensus prescribes screening by indirect immunofluorescence on neutrophils. We evaluated the first automated ANCA-pattern recognition system. C-ANCA (n = 39) and P-ANCA (n = 40) samples were selected from patients with ANCA-associated vasculitis (AAV). Non-AAV controls included sera from healthy controls (n = 40), sera with possible interfering antibodies (n = 46), or miscellaneous ANCA reactivity (n = 31). ANCA slides were analysed by AKLIDES and routine fluorescence microscopy. The C-ANCA pattern was recognized by routine microscopy in 92% and 97% on ethanol- and formalin-fixed slides, respectively. AKLIDES reported C-ANCA in 74% and 95%, respectively. P-ANCA was recognized by routine microscopy on ethanol-fixed neutrophils in 90%, while AKLIDES reported P-ANCA in 80%. Typically, only 65% and 33% of these samples showed the expected C-ANCA on formalin-fixed neutrophils by routine microscopy and AKLIDES, respectively. A C- or P-ANCA pattern was observed on ethanol-fixed neutrophils in 28% and 23% of the controls by routine microscopy and AKLIDES, respectively. Only 5% of the controls revealed C-ANCA on formalin-fixed neutrophils by routine microscopy and AKLIDES. Altogether, automated ANCA-pattern recognition by AKLIDES is promising. Distinction of C- and P-ANCA is good, but sensitivity on ethanol-fixed neutrophils needs improvement. When optimized, pattern recognition software may play an important role in AAV diagnostics.

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Section: Discussionmentioning

confidence: 99%