What is the role of autoantibody tests in the workup of vasculitis?

Updated: Dec 10, 2018
  • Author: Nadia Jennifer Chiara Luca, MD; Chief Editor: Lawrence K Jung, MD  more...
  • Print
Answer

The initial test for antineutrophil cytoplasmic antibody (ANCA) is indirect immunofluorescence to detect staining pattern, either cytoplasmic or perinuclear.

If positive results are noted, test for reactivity to proteinase 3 (PR3) and myeloperoxidase (MPO) by enzyme-linked immunoassay (ELISA)

ANCA positivity is noted in approximately 90% of pediatric patients with granulomatosis with polyangiitis (GPA) (formerly Wegener granulomatosis), 79% of who are cytoplasmic. [6]

PR3-ANCA and MPO-ANCA positivity have a high sensitivity and specificity for the diagnosis of GPA and microscopic polyangiitis (MPA), respectively.

The association of Churg-Strauss syndrome and ANCA positivity is approximately 40%.

Note that an atypical ANCA finding is nonspecific and may be seen in other inflammatory conditions such as infection and inflammatory bowel disease.

Anti-glomerular basement membrane (GBM) antibody testing is indicated for pulmonary renal syndromes.

Other autoantibodies such as anti-nuclear antibody (ANA) and rheumatoid factor (RF) are rarely positive


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!