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Arch Pathol Lab Med. 2016 Jun;140(6):524-8. doi: 10.5858/arpa.2015-0221-CP.

Variability in Testing for Antineutrophil Cytoplasmic Antibodies: A Survey of Participants in the College of American Pathologists Proficiency Testing Program.

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From the Department of Laboratory Medicine, University of California, San Francisco (Dr Karlon); Quest Diagnostics Nichols Institute, San Juan Capistrano, California (Dr Naides); the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (Dr Crosson); and the Department of Clinical Pathology, Cleveland Clinic, Cleveland, Ohio (Dr Ansari).



-Variability in testing for antineutrophil cytoplasmic antibodies (ANCAs) contributes to confusion and controversy related to testing for vasculitis and other ANCA-associated diseases.


-To survey laboratory testing practices regarding ANCA testing and to investigate differences in testing algorithms.


-Supplemental questions were sent to the 333 laboratories participating in the College of American Pathologists proficiency testing program for ANCA as part of the Special Immunology S2 Survey.


-A total of 315 laboratories submitted responses to the supplemental questions. Only 88 of 315 participants (28%) reported using a combination of indirect immunofluorescence (IFA) and enzyme immunoassay (EIA) techniques as recommended by current guidelines, with a few additional labs using IFA and multiplex bead assay as an acceptable alternative to EIA. Other labs reported using only IFA, EIA, or multiplex bead assays.


-A wide variety of testing algorithms are in use for ANCA testing despite evidence to suggest that a combination of IFA and EIA testing provides the most comprehensive information. Laboratories should inform clinicians clearly about testing practices and utility of testing in specific disease states.

[Indexed for MEDLINE]

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