Audit of the clinical usefulness of a rapid qualitative ELISA screen for antimyeloperoxidase and antiproteinase 3 antibodies in the assessment of patients with suspected vasculitis. Issue 10 (26th September 2003)

• Record Type: Journal Article
• Authors: Aslam, A; Newman, T L; Misbah, S A
• Is Part Of: Journal of clinical pathology. Volume 56:Issue 10(2003)
• Page Start: 775
• Page End: 777
• Publication Date: 2003-09-26
• Subjects: antineutrophil cytoplasmic antibodies -- antimyeloperoxidase antibodies -- antiproteinase 3 antibodies -- vasculitis -- enzyme linked immunosorbent assay; ANCA, antineutrophil cytoplasmic antibodies -- ELISA, enzyme linked immunosorbent assay -- IIF, indirect immunofluorescence -- MPO, myeloperoxidase -- OD, optical density -- PR3, proteinase 3; Pathology -- Periodicals; Pathology, Molecular -- Periodicals; 616.0705
• DOI: 10.1136/jcp.56.10.775
• Languages: English
• ISSNs: 0021-9746

Abstract

Abstract : Background: The need for urgent antineutrophil cytoplasmic antibody (ANCA) results when assessing patients with acute renal failure, pulmonary renal syndrome, or mononeuritis multiplex has led to the development of a rapid qualitative ELISA screening assay for antibodies to myeloperoxidase (MPO) and proteinase 3 (PR3). Aims: To report the use of a rapid qualitative ELISA screen for PR3-ANCA and MPO-ANCA in a regional immunology laboratory and its correlation with standard indirect immunofluorescence (IIF) and quantitative ELISA for PR3-ANCA and MPO-ANCA. Methods: Over 12 months, 103 samples requiring urgent ANCA testing were screened by a rapid qualitative ELISA and the results compared with IIF and quantitative ELISA assays for PR3-ANCA and MPO-ANCA. Results: There was an excellent correlation between the rapid qualitative ELISA and standard ANCA IIF and a routine ELISA for MPO/PR3-ANCA, with sensitivities ranging from 82% to 100%. There were two false negatives, which gave weak to moderately positive values as determined by routine ELISA. However, the clinical relevance of these two cases is doubtful. Conclusions: The rapid ELISA for anti-MPO and anti-PR3 correlates well with quantitative ELISA and IIF ANCA, and urgent management decisions in patients with suspected small vessel vasculitis can be based with confidence on this test.