Department of Microbiology and Immunology, University of Leuven and Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Herestraat 49, 3000 Leuven, Belgium.
Maastricht University, Universiteitssingel 40, 6229 Maastricht, Netherlands.
Nat Rev Rheumatol. 2017 Nov;13(11):683-692. doi: 10.1038/nrrheum.2017.140. Epub 2017 Sep 14.
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.
抗中性粒细胞胞浆抗体（ANCA）是用于诊断明确的小血管血管炎的有价值的实验室标志物，包括肉芽肿性多血管炎（GPA）和显微镜下多血管炎（MPA）。根据 1999 年关于 ANCA 检测的国际共识，间接免疫荧光法（IIF）应用于筛查 ANCAs，然后应通过蛋白酶 3（PR3）-ANCAs 和髓过氧化物酶（MPO）-ANCAs 的免疫测定来检测含有 ANCAs 的样本。PR3-ANCAs 和 MPO-ANCAs 的区分具有重要的临床和发病机制意义。随着用于 PR3-ANCAs 和 MPO-ANCAs 的可靠免疫测定变得广泛可用，越来越多的国际共识认为高质量的免疫测定是诊断 ANCA 相关性血管炎的首选筛选方法。本共识声明提出，高质量的免疫测定可作为疑似患有 GPA 和 MPA 的 ANCAs 相关性血管炎患者的主要筛查方法，而无需明确进行 IIF，并提出和讨论了支持这一建议的证据。
