TY - JOUR
T1 - 2020 international consensus on ANCA testing beyond systemic vasculitis
AU - Moiseev, Sergey
AU - Tervaert, Jan Willem Cohen
AU - Arimura, Yoshihiro
AU - Bogdanos, Dimitrios P.
AU - Csernok, Elena
AU - Damoiseaux, Jan
AU - Ferrante, Marc
AU - Flores-Suarez, Luis Felipe
AU - Fritzler, Marvin J.
AU - Invernizzi, Pietro
AU - Jayne, David
AU - Jennette, J. Charles
AU - Little, Mark A.
AU - McAdoo, Stephen P.
AU - Novikov, Pavel
AU - Pusey, Charles D.
AU - Radice, Antonella
AU - Salama, Alan D.
AU - Savige, Judith A.
AU - Segelmark, Marten
AU - Shoenfeld, Yehuda
AU - Sinico, Renato A.
AU - Sousa, Maria-Jose
AU - Specks, Ulrich
AU - Terrier, Benjamin
AU - Tzioufas, Athanasios G.
AU - Vermeire, Severine
AU - Zhao, Ming-Hui
AU - Bossuyt, Xavier
N1 - Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/9
Y1 - 2020/9
N2 - This document follows up on a 2017 revised international consensus on anti-neutrophil cytoplasm antibodies (ANCA) testing in granulomatosis with polyangiitis and microscopic polyangiitis and focuses on the clinical and diagnostic value of ANCA detection in patients with connective tissue diseases, idiopathic interstitial pneumonia, autoimmune liver diseases, inflammatory bowel diseases, anti-glomerular basement membrane (GBM) disease, infections, malignancy, and during drug treatment. Current evidence suggests that in certain settings beyond systemic vasculitis, ANCA may have clinical, pathogenic and/or diagnostic relevance. Antigen specific ANCA targeting proteinase-3 and myeloperoxidase should be tested by solid phase immunoassays in any patient with clinical features suggesting ANCAassociated vasculitis and in all patients with anti-GBM disease, idiopathic interstitial pneumonia, and infective endocarditis associated with nephritis, whereas in patients with other aforementioned disorders routine ANCA testing is not recommended. Among patients with autoimmune liver diseases or inflammatory bowel diseases, ANCA testing may be justified in patients with suspected autoimmune hepatitis type 1 who do not have conventional autoantibodies or in case of diagnostic uncertainty to discriminate ulcerative colitis from Crohn's disease. In these cases, ANCA should be tested by indirect immunofluorescence as the target antigens are not yet well characterized. Many questions concerning the optimal use of ANCA testing in patients without ANCA-associated vasculitis remain to be answered.
AB - This document follows up on a 2017 revised international consensus on anti-neutrophil cytoplasm antibodies (ANCA) testing in granulomatosis with polyangiitis and microscopic polyangiitis and focuses on the clinical and diagnostic value of ANCA detection in patients with connective tissue diseases, idiopathic interstitial pneumonia, autoimmune liver diseases, inflammatory bowel diseases, anti-glomerular basement membrane (GBM) disease, infections, malignancy, and during drug treatment. Current evidence suggests that in certain settings beyond systemic vasculitis, ANCA may have clinical, pathogenic and/or diagnostic relevance. Antigen specific ANCA targeting proteinase-3 and myeloperoxidase should be tested by solid phase immunoassays in any patient with clinical features suggesting ANCAassociated vasculitis and in all patients with anti-GBM disease, idiopathic interstitial pneumonia, and infective endocarditis associated with nephritis, whereas in patients with other aforementioned disorders routine ANCA testing is not recommended. Among patients with autoimmune liver diseases or inflammatory bowel diseases, ANCA testing may be justified in patients with suspected autoimmune hepatitis type 1 who do not have conventional autoantibodies or in case of diagnostic uncertainty to discriminate ulcerative colitis from Crohn's disease. In these cases, ANCA should be tested by indirect immunofluorescence as the target antigens are not yet well characterized. Many questions concerning the optimal use of ANCA testing in patients without ANCA-associated vasculitis remain to be answered.
KW - ANTI-SACCHAROMYCES-CEREVISIAE
KW - ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES
KW - AUTOIMMUNE LIVER DISORDERS
KW - BACTERICIDAL/PERMEABILITY-INCREASING PROTEIN
KW - CLINICAL-SIGNIFICANCE
KW - INFLAMMATORY-BOWEL-DISEASE
KW - MICROSCOPIC POLYANGIITIS
KW - PRIMARY SCLEROSING CHOLANGITIS
KW - PRIMARY SJOGRENS-SYNDROME
KW - RHEUMATOID-ARTHRITIS
KW - TUBULIN ISOTYPE 5
U2 - 10.1016/j.autrev.2020.102618
DO - 10.1016/j.autrev.2020.102618
M3 - (Systematic) Review article
C2 - 32663621
SN - 1568-9972
VL - 19
JO - Autoimmunity Reviews
JF - Autoimmunity Reviews
IS - 9
M1 - 102618
ER -