ELISA is the superior method for detecting antineutrophil cytoplasmic antibodies in the diagnosis of systemic necrotising vasculitis
| Autor: | David Gillis, M. Vadas, Wendy Pollock, A. Harris, Judy Savige, P. Gambel, M Trevisin, G. Chang, Paul J Neeson |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Vasculitis Systemic disease Pathology medicine.medical_specialty Letter Adolescent Population Fluorescent Antibody Technique Enzyme-Linked Immunosorbent Assay Sensitivity and Specificity Serology Pathology and Forensic Medicine Antibodies Antineutrophil Cytoplasmic Predictive Value of Tests Biopsy Necrotizing Vasculitis medicine Humans Prospective Studies education Child Necrotising vasculitis Anti-neutrophil cytoplasmic antibody Aged Aged 80 and over education.field_of_study medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease ROC Curve Predictive value of tests Female business Biomarkers Research Article Follow-Up Studies |
| Zdroj: | Journal of clinical pathology. 52(9) |
| ISSN: | 0021-9746 |
| Popis: | BACKGROUND: Antineutrophil cytoplasmic antibodies (ANCA) have been used as a diagnostic marker for systemic necrotising vasculitis, a disease classification which includes Wegener granulomatosis, microscopic and classic polyarteritis nodosa, and Churg Strauss disease. OBJECTIVE: To compare the diagnostic value of the two methods for detecting these antibodies--immunofluorescence and enzyme linked immunosorbent assay (ELISA)--with respect to biopsy proven active systemic necrotising vasculitis in a clinically relevant population. METHODS: A prospective study to ascertain the patient's diagnosis at the time of each of the 466 requests for ANCA received at one laboratory over a nine month period, and allocate each to one of five diagnostic groups: active and inactive biopsy proven systemic necrotising vasculitis, suspected systemic necrotising vasculitis, low probability systemic necrotising vasculitis, and not systemic necrotising vasculitis. RESULTS: ELISA was superior to immunofluorescence in the diagnosis of systemic necrotising vasculitis because it was less likely to detect other diseases. This was reflected in its specificity of 97% and positive predictive value of 73%, compared with 90% and only 50% for immunofluorescence (p = 0.0006 and p = 0.013, respectively). ELISA had a negative predictive value of 98% which was not significantly different to immunofluorescence. ELISA was technically superior. CONCLUSIONS: ELISA is the superior method of ANCA detection in the diagnosis of systemic necrotising vasculitis and should be used in conjunction with a compatible clinical picture and histological evidence. |
| Databáze: | OpenAIRE |
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