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Chapter 94 : Antineutrophil Cytoplasmic Antibodies (ANCA) and Strategies for Diagnosing ANCA-Associated Vasculitides

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Antineutrophil Cytoplasmic Antibodies (ANCA) and Strategies for Diagnosing ANCA-Associated Vasculitides, Page 1 of 2

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Abstract:

Inflammation of and damage to blood vessel walls are the shared defining features of all vasculitides. The symptoms vary depending on the size of the vessels affected, the organs they serve, the underlying cause of the vasculitis, and the activity of the disease. The vasculitic diseases are rare. Since there are only 20 to 50 new cases of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides per 1,000,000 people per year (1, 2), a systematic and thorough diagnostic algorithm is needed to correctly identify patients with the disease (3, 4). Missed or delayed diagnosis can result in permanent organ injury or even death (5, 6).

Citation: Burlingame R, Buchner C, Hanly J, Walsh N. 2016. Antineutrophil Cytoplasmic Antibodies (ANCA) and Strategies for Diagnosing ANCA-Associated Vasculitides, p 909-916. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch94
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Figures

Image of FIGURE 1
FIGURE 1

Indirect immunofluorescence of a PR3-ANCA-positive sample expressing cytoplasmic staining with interlobular accentuation on both ethanol-fixed (A) and formalin-fixed (B) neutrophils.

Citation: Burlingame R, Buchner C, Hanly J, Walsh N. 2016. Antineutrophil Cytoplasmic Antibodies (ANCA) and Strategies for Diagnosing ANCA-Associated Vasculitides, p 909-916. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch94
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Image of FIGURE 2
FIGURE 2

Indirect immunofluorescence of an MPO-ANCA-positive sample expressing perinuclear staining on ethanol-fixed neutrophils (A) and cytoplasmic staining with interlobular accentuation on formalin-fixed neutrophils (B).

Citation: Burlingame R, Buchner C, Hanly J, Walsh N. 2016. Antineutrophil Cytoplasmic Antibodies (ANCA) and Strategies for Diagnosing ANCA-Associated Vasculitides, p 909-916. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch94
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Image of FIGURE 3
FIGURE 3

Photomicrograph of a skin biopsy displaying features of a leukocytoclastic vasculitis, such as that caused by ANCA. (A) At medium power, capillaries in the upper dermis, denoted by the white arrows, appear to have prominent thickened walls. These can be contrasted with normal dermal vessels denoted by the black arrow. Red blood cell extravasation is an additional feature. (B) At high power, the abnormal capillary wall displays fibrinoid change in association with a neutrophil-rich intramural inflammatory infiltrate.

Citation: Burlingame R, Buchner C, Hanly J, Walsh N. 2016. Antineutrophil Cytoplasmic Antibodies (ANCA) and Strategies for Diagnosing ANCA-Associated Vasculitides, p 909-916. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch94
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Image of FIGURE 4
FIGURE 4

Clinical photograph of a patient with palpable purpura on the legs. This is a cutaneous manifestation of a leukocytoclastic vasculitis, such as that caused by ANCA.

Citation: Burlingame R, Buchner C, Hanly J, Walsh N. 2016. Antineutrophil Cytoplasmic Antibodies (ANCA) and Strategies for Diagnosing ANCA-Associated Vasculitides, p 909-916. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch94
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