Abstract
Background:
Detection of anti-neutrophil cytoplasmic antibodies (ANCA) is important for the diagnosis of the ANCA-associated vasculitides (AAV). For AAV, especially ANCA directed against myeloperoxidase (MPO) and proteinase 3 (PR3) are most relevant. ANCA with less well-defined specificities may, however, also be detected in other inflammatory and non-inflammatory conditions.
Methods:
A questionnaire, initiated by the European Autoimmunity Standardisation Initiative (EASI), was used to gather information on methods and testing algorithms used for ANCA in clinical laboratories of 12 European countries (EASI survey).
Results:
Four hundred and twenty-nine responses were included in the EASI survey analysis which revealed differences within countries and between countries. Laboratories overall were poor in adherence to international consensus on ANCA testing. Substantial variation was observed with respect to the use of ANCA indirect immunofluorescence (IIF) in the algorithm, application of distinct methods for MPO- and PR3-ANCA, the daily availability of new ANCA results, and interpretation of test results.
Conclusions:
Awareness of these differences may stimulate further harmonization and standardization of ANCA testing. This may be promoted by an update of the international ANCA consensus and the introduction of international standards.
Acknowledgments
Dr. Caroline Roozendaal (University Medical Center Groningen, The Netherlands) is greatly acknowledged for her help in constructing the original questionnaire. Also, all the members of the national EASI-teams are acknowledged for their collaboration. In Italy EASI is integrated into the Italian Forum on Autoimmune Disease Research (FIRMA). In Switzerland the EASI activities are covered by the Commission of Laboratory Diagnostics of the Swiss Society for Allergology and Immunology (SSAI). In Spain EASI activities are coordinated by the Spanish Group of Autoimmunity (GEAI). Finally, we also thank all the laboratory specialists who returned the completed questionnaire.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment of leadership: None declared.
Honorarium: None declared.
Competing interests: None declared.
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