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Nephrol Dial Transplant. 2006 Feb;21(2):397-401. Epub 2005 Oct 18.

Anti-glomerular basement membrane antibodies in the diagnosis of Goodpasture syndrome: a comparison of different assays.

Author information

1
Unità Operativa di Immunologia Clinica, Dipartimento Area Medica, Azienda Ospedaliera Ospedale San Carlo Borromeo, Milano, Italy. renatoalberto.sinico@fastwebnet.it

Abstract

BACKGROUND:

The role of anti-glomerular basement membrane (GBM) antibodies in the pathogenesis of Goodpasture syndrome (GPS) is firmly established. Untreated, the disease may follow a fulminating course. Early identification of patients has important implications in terms of management and prognosis. Therefore, a diagnostic test for the determination of circulating anti-GBM antibodies, of very high sensitivity and specificity, is necessary. A number of assays, using different antigenic substrates, are available, but studies comparing the 'performances' of the different tests are scarce.

METHODS:

The aim of our work was to evaluate the sensitivity and specificity of four immunoassay-based anti-GBM antibodies kits. Thirty-four serum samples from 19 GPS patients, 41 pathological and 28 normal controls were studied retrospectively (the follow-up samples were not included in the analysis of performance data). Cut-off limits were derived from receiver operating characteristics curve analysis.

RESULTS:

All the assays showed a comparable good sensitivity (between 94.7 and 100.0%), whereas specificity varied considerably (from 90.9 to 100.0%). The better performance in terms of sensitivity/specificity was achieved by a fluorescence immunoassay which utilizes a recombinant antigen.

CONCLUSION:

All the assays have a good performance, with high sensitivity; however, the specificity may vary considerably.

PMID:
16234289
DOI:
10.1093/ndt/gfi230
[Indexed for MEDLINE]

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