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- Title
A Dual-Fixed Neutrophil Substrate Improves Interpretation of Antineutrophil Cytoplasmic Antibodies by Indirect Immunofluorescence.
- Authors
Ming-Wei Lin; Silvestrini, Roger A.; Culican, Suzanne; Campbell, David; Fulcher, David A.
- Abstract
Objectives: To determine whether the addition of a formalin-fixed neutrophil substrate could improve interpretation and prediction of autoantigenic specificity in antineutrophil cytoplasmic antibody (ANCA) testing. Methods: Routine diagnostic samples sent for ANCA testing were analyzed prospectively on a dual substrate of both ethanol- and formalin-fixed neutrophils. Positive samples on ethanol-fixed neutrophils were deemed "typical" if formalin-fixed neutrophils also stained, and "atypical" if not. Indirect immunofluorescence (IIF) results were correlated with antimyeloperoxidase (MPO) and anti-proteinase 3 (PR3) results with an enzyme-linked immunosorbent assay (ELISA). Results: Of 1,426 samples, 201 from unique patients were ANCA-positive (200 on IIF, 1 on ELISA alone). Thirty-two (45%) of 71 typical ANCA staining patterns were positive for either an anti-MPO or anti-PR3 antibodies, whereas only one (0.8%) of 129 atypical patterns was ELISA-positive, in a patient without systemic vasculitis. Only one (3%) of 34 ELISA-positive samples had a negative IIF-ANCA (1/1,426 patients, 0.07%), and this patient did not have vasculitis. Conclusions: Concomitant staining on formalin fixation of IIF-positive ethanol-fixed ANCA samples improves the interpretation of ANCA testing and is predictive of vasculitis autoantigens MPO and PR3.
- Subjects
VASCULITIS; NEUTROPHILS; IMMUNOFLUORESCENCE; ENZYME-linked immunosorbent assay; IMMUNOGLOBULINS
- Publication
American Journal of Clinical Pathology, 2014, Vol 142, Issue 3, p325
- ISSN
0002-9173
- Publication type
Article
- DOI
10.1309/AJCPG02FGQVAUSIU