Fluorescent Antiglobulin Studies in Leukopenic and Related Disorders *

Calabresi, Paul; Edwards, Earl A.; Schilling, Robert F.

doi:10.1172/jci103987

Cited by 106 publications

(21 citation statements)

References 54 publications

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“…1 and has been previously described elsewhere 13,14 . Although ANCAs were initially discovered in 1959 in patients with chronic inflammatory disorders 15 , the association between vasculitis (in particular glomerulonephritis) and autoantibodies reacting with cytoplasmic components of neutrophils only became apparent in 1982 (REF. 16).…”

Section: Historical Perspectivementioning

confidence: 99%

Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis

et al. 2017

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| Anti-neutrophil cytoplasmic antibodies (ANCAs) are valuable laboratory markers used for the diagnosis of well-defined types of small-vessel vasculitis, including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). According to the 1999 international consensus on ANCA testing, indirect immunofluorescence (IIF) should be used to screen for ANCAs, and samples containing ANCAs should then be tested by immunoassays for proteinase 3 (PR3)-ANCAs and myeloperoxidase (MPO)-ANCAs. The distinction between PR3-ANCAs and MPO-ANCAs has important clinical and pathogenic implications. As dependable immunoassays for PR3-ANCAs and MPO-ANCAs have become broadly available, there is increasing international agreement that high-quality immunoassays are the preferred screening method for the diagnosis of ANCA-associated vasculitis. The present Consensus Statement proposes that high-quality immunoassays can be used as the primary screening method for patients suspected of having the ANCA-associated vaculitides GPA and MPA without the categorical need for IIF, and presents and discusses evidence to support this recommendation.NATURE REVIEWS | RHEUMATOLOGY VOLUME 13 | NOVEMBER 2017 | 683 CONSENSUS STATEMENT © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .Given the improvements in antigen-specific immuno assays, the international consensus on the testing of ANCAs in small-vessel vasculitis seems in need of updating [7][8][9][10] . In this manuscript, a revised 2017 international consensus is proposed by a group of international experts (from North and Central America, Australia, Europe and Asia) in the ANCA field. This Consensus Statement highlights the value of ANCA testing as a tool for diagnosis (but not follow-up) of GPA and MPA and gives a historical perspective of ANCAs in small-vessel vasculitis. This Consensus Statement does not, however, present evidence-based guidelines or a meta-analysis. MethodsThis Consensus Statement was prepared by a group of experts from four European laboratories (X.B., J.D., N.R., J.W.C.T. and E.C.) in person and by correspondence. The draft was circulated to each contributor and modified, and the resulting document was distributed by e-mail to 16 experts from four continents, selected based on their expertise and knowledge in clinical and/or laboratory aspects of AAV. This revised document resulted in a second round of discussions and revisions. The final document was returned to all contributors for ratification.The Consensus Statement is based on the results of a multicentre European Vasculitis Study Group (EUVAS) evaluation of the value of IIF versus antigen-specific immunoassays for ANCA detection 6,11,12 . This study, which showed a large variability between different IIF methods and a good diagnostic performance of PR3-ANCA and MPO-ANCA immunoassays 6 , indicated that the 1999 international consensus on ANCA testing for AAV needed revision. When the consensus was put toget...

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Section: Historical Perspectivementioning

confidence: 99%

Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis

et al. 2017

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“…All four patients with splenomegaly and seven of the nine who suffered joint manifestations had positive antinuclear tests. (20,(25)(26)(27). In every case, the sera studied for affinity to calf thymus nucleoprotein were also tested against fixed whole nuclei of normal peripheral blood leukocytes, but in some cases only the latter test was performed.…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies have shown the presence of circulating antinuclear globulins in patients with systemic lupus erythematosus as well as in cases of rheumatoid arthritis, complicated by splenomegaly and leukopenia (Felty's syndrome) (20). In had previously undergone colectomy for this disorder.…”

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confidence: 99%

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confidence: 99%

“…The details of the technique used have been reported previously (20). Briefly, the test sera were superimposed for 1 hour on: 1) normal human peripheral blood smears fixed in 95 per cent ethanol (20), and on 2) nucleohistone spots prepared from calf thymocytes (22,23). The slides were thoroughly washed and fluorescein-labeled rabbit antihuman -y-globulin, absorbed with rat liver powder, was then used as a histochemical stain for human y-globulin.…”

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Demonstration of Circulating Antinuclear Globulins in Ulcerative Colitis*

Calabresi¹,

Thayer²,

Spiro³

1961

J. Clin. Invest.

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Although Andresen (1) first considered "allergy" as a factor in the pathogenesis of ulcerative colitis in 1925, the recent studies of Levine, Kirsner, Klotz and Elchlepp (2-4) have renewed interest for the role of hypersensitivty in this disorder. Various clinical features suggest the presence of an altered immune state in ulcerative colitis. Among these are sensitivity to drugs and blood transfusion (5), the beneficial effects of ACTH and corticosteroids (6) and such extracolonic manifestations as erythema nodosum (7), uveitis (8), hepatitis (9, 10), myocarditis (6), glomerulitis (5, 11), arthritis (12-14), purpura (5) had previously undergone colectomy for this disorder. Four patients were studied before and after colectomy and are included in both groups. Over 300 sera from normal subj ects and from patients with various disease states were tested while the study was in progress.Whenever multiple tests were performed, aliquots of the same serum sample were used. All sera were stored at -200 C.Fluorescent antiglobulin tests. The details of the technique used have been reported previously (20). Briefly, the test sera were superimposed for 1 hour on: 1) normal human peripheral blood smears fixed in 95 per cent ethanol (20), and on 2) nucleohistone spots prepared from calf thymocytes (22, 23). The slides were thoroughly washed and fluorescein-labeled rabbit antihuman -y-globulin, absorbed with rat liver powder, was then used as a histochemical stain for human y-globulin. The first procedure tests the affinity of the sera for human leukocyte whole nuclei and the fluorescent label is detected by ultraviolet microscopy. In the second method, the sera are tested against calf nucleoprotein and fluorescence is visible to the naked eye when the slides are exposed to the beam of a Woods lamp.Lupus erytheniatosus (LE) cell preparations. The technique used was a variation of the Zinkham-Conley method (24). One ml of heparinized normal blood was added to 0.5 ml of test serum. After standing at room temperature for 2 hours with occasional shaking, 1.5 ml of the mixture was transferred to screw-top tubes containing glass beads and rotated at 40 rpm for 30 minutes at 370 C. The contents were then centrifuged in smallbore tubes to isolate the buffy coat which was smeared on glass coverslips, stained with Wright-Giesma and examined microscopically for the presence of LE cells.Rheumatoid

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Antinuclear Factor in Light Sensitivity and Lupus Erythematosus

Peterson¹

1963

Arch Dermatol

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Fluorescent Antiglobulin Studies in Leukopenic and Related Disorders *

Cited by 106 publications

References 54 publications

Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis

Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis

Demonstration of Circulating Antinuclear Globulins in Ulcerative Colitis*

Antinuclear Factor in Light Sensitivity and Lupus Erythematosus

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