ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2642

ANCA Testing: Final Diagnoses in Cases with Positive Immunofluorescence and Negative ELISA

‪Gabriel Breuer‬‏1, Bashar Fteiha 1, Alon Benaya 1, Marwan Abu Sneineh‬‏ 1 and Gideon Nesher 1, 1Shaare Zedek Medical Center, Jerusalem, Yerushalayim, Israel

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: AAV and Diagnostic Tests, ANCA, Enzyme-Linked Immunoabsorbant Assays (ELISA), IF

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Tuesday, November 12, 2019

Session Title: Vasculitis – ANCA-Associated Poster I

Session Type: Poster Session (Tuesday)

Session Time: 9:00AM-11:00AM

Background/Purpose: With the widespread availability of anti-neutrophil cytoplasmic antibody (ANCA) testing, interpreting positive results has become increasingly challenging. In addition to ANCA Associated Vasculitis (AAV), the spectrum of diseases associated with ANCAs has broadened to include a wide range of other inflammatory and infectious diseases including Inflammatory bowel disease, systemic lupus erythematosus, rheumatoid arthritis and drug-induced vasculitis, calling into question the diagnostic implications of ANCA positivity in a hospital setting. Immunofluorescence (IF) on ethanol-fixed neutrophils is used to detect ANCA, which can be divided into three patterns; cytoplasmic ANCA (c-ANCA), perinuclear ANCA (p-ANCA) and atypical ANCA (a-ANCA). Enzyme-linked immunosorbent assay (ELISA) is used in diagnostic laboratories to detect ANCA to specific antigens. The most common antigens used in ELISA testing are myeloperoxidase (MPO) and proteinase-3 (PR3).

Discrepancies may exist between IF and ELISA ANCA testing. We studied cases with positive ANCA IF testing but negative ELISA for both MPO and PR3, looking for their final diagnoses.

Methods:  ANCA tests performed between 2000-2018 were identified using the medical center  laboratory  data system. Of those, all cases with negative MPO and PR3 testing were collected. Medical records of those cases were retrieved to look for their clinical features and final diagnoses.

Results: 9189 ANCA tests were ordered between the years 2000-2018 of which 549 (5.9% were positive by at least one method. 114 (1.2%) cases showed discrepancy, 93 (0.01%) were ANCA IF-positive ELISA-negative. 62 were a-ANCA positive, 22 were p-ANCA positive and 9 were c-ANCA positive. Only 2 case were diagnosed with AAV, both had p-ANCA. All other patients had a broad spectrum of diagnoses, including autoimmune, infectious, and other conditions involving the renal, hepatic, cardiovascular, and central nervous systems (Table 1, Figure 1).

Conclusion: Diagnosis of AAV is highly unlikely in cases with ANCA IF-positive ELISA-negative. 


ACR 2019 Table 1


ACR 2019 Fgure 1


Disclosure: G. Breuer‬‏, None; B. Fteiha, None; A. Benaya, None; M. Abu Sneineh‬‏, None; G. Nesher, None.

To cite this abstract in AMA style:

Breuer‬‏ G, Fteiha B, Benaya A, Abu Sneineh‬‏ M, Nesher G. ANCA Testing: Final Diagnoses in Cases with Positive Immunofluorescence and Negative ELISA [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/anca-testing-final-diagnoses-in-cases-with-positive-immunofluorescence-and-negative-elisa/. Accessed January 27, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2019 ACR/ARP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/anca-testing-final-diagnoses-in-cases-with-positive-immunofluorescence-and-negative-elisa/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.