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Antineutrophil Cytoplasm Antibodies (ANCAs) and Strategy for Diagnosing ANCA-Associated Vasculitides, Page 1 of 2
< Previous page Next page > /docserver/preview/fulltext/10.1128/9781555815905/9781555813642_Chap118-1.gif /docserver/preview/fulltext/10.1128/9781555815905/9781555813642_Chap118-2.gifAbstract:
This chapter concentrates on vasculitides which are associated with presence of antineutrophil cytoplasm antibodies (ANCAs), it focuses on idiopathic smallvessel vasculitides (SVV), and mentions some of the clinical conditions where other types of neutrophil-specific autoantibodies (NSA) are commonly produced. The diagnosis of a primary vasculitic condition must rest on sound clinical judgment of more or less characteristic constellations of symptoms and features, with some being indicative of vasculitis and others reflecting just a general inflammatory condition (arthralgias, fever, fatigue, loss of appetite, hypersedimentation). Although the chapter focuses on the methodologies used to detect ANCAs, it also stresses important aspects of setting clinically validated assay cutoff values, controlling laboratory performance quality, knowing frequent pitfalls, and how to exercise troubleshooting. It also mentions possibilities for reporting laboratory data with due consideration toward differential diagnostics, potential clinical utility, and interpretation. Monoclonal mouse antibodies to proteinase 3 (PR3), myeloperoxidase (MPO), and elastase (EL) have been used to capture the respective antigens from cell extracts, and the captured antigen has then been used as the target in an enzyme-linked immunosorbent assay (ELISA).