{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T04:54:08Z","timestamp":1764996848562},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"840","license":[{"start":{"date-parts":[[1995,10,1]],"date-time":"1995-10-01T00:00:00Z","timestamp":812505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1995,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We have reviewed the medical records of 301\/327 consecutive patients in whom anti-neutrophil cytoplasmic antibodies (ANCA) were detected by the Regional Immunology Laboratory in Northern Ireland between January 1988 and October 1991 (45 months). We have collected data for each patient regarding age, sex, smoking habit, area of residence, and details of any other autoantibody activity. Clinical diagnosis was established, with the number of organ systems involved and the evidence for that involvement (symptomatic, biochemical, radiological, and histological). Diagnoses were divided into four groups according to their recognised vasculitic features and these were related to the pattern of immunofluorescence and maximum ANCA titre detected. The most frequent diagnosis was rheumatoid arthritis (18.2% of patients) and the connective tissue disorders as a whole accounted for 27.9% of patients. ANCA were also detected in a wide range of clinical conditions which are not associated with vasculitis and these patients were an important source of \u2018false-positives\u2019. The positive predictive value (PPV) of ANCA of all patterns and titres for vasculitic conditions was 27%, however, the detection of a classical ANCA pattern at high titre (&amp;gt; or = 1:640) was associated with an increased PPV of 75%. The coexistence of an antinuclear antibody (ANA) reduces the PPV of both classical and perinuclear ANCA, although perinuclear ANCA with antimyeloperoxidase specificity had an improved PPV. We conclude that ANCA testing should not be used as the only screening investigation for vasculitis but should be included in a rational investigative scheme. The interpretation of a positive ANCA result must take into account the presence of other autoantibodies and the full range of non-vasculitic conditions when the clinical situation is not typical of vasculitis.<\/jats:p>","DOI":"10.1136\/pgmj.71.840.605","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:25:21Z","timestamp":1230585921000},"page":"605-612","source":"Crossref","is-referenced-by-count":18,"title":["An audit of ANCA in routine clinical practice"],"prefix":"10.1093","volume":"71","author":[{"given":"J D","family":"Edgar","sequence":"first","affiliation":[{"name":"Department of Immunology, Queen\u2019s Medical Centre , Nottingham, NG7 2UH , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S A","family":"McMillan","sequence":"additional","affiliation":[{"name":"Regional Immunology Laboratory, Belfast City Hospital , Belfast, N Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I N","family":"Bruce","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Royal Victoria and Musgrave Park Hospitals , Belfast, N Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S K","family":"Conlan","sequence":"additional","affiliation":[{"name":"Regional Immunology Laboratory, Belfast City Hospital , Belfast, N Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1995,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1136\/bmj.285.6342.606","article-title":"Segmental necrotising glomerulonephritis with antineutrophil antibody: possible arbovirus aetiology?","volume":"285","author":"Davies, D.J.; Moran, J.E.; Niall, J.F.; Ryan, G.B.","year":"1982","unstructured":"Davies DJ, Moran JE, Niall JF, Ryan GB. 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Antineutrophil cytoplasmic autoantibodies and associated diseases: a review. Am J Kidney Dis 1990; 15: 517-29.","journal-title":"Am J Kidney Dis"},{"key":"ref_4","first-page":"1","article-title":"ANCA and associated diseases: immunodiagnostic and pathogenetic aspects","volume":"91","author":"Gross, W.L.; Schmitt, W.H.; Csernok, E.","year":"1993","unstructured":"Gross WL, Schmitt WH, Csernok E. ANCA and associated diseases: immunodiagnostic and pathogenetic aspects. Clin Exp Immunol 1993; 91: 1-12.","journal-title":"Clin Exp Immunol"},{"issue":"1","key":"ref_5","first-page":"7","article-title":"The clinical relevance of ANCA in vasculitis. Clin Exp Immunol","volume":"93","author":"Gross, W.L.; Hauschild, S.; Mistry, N.","year":"1993","unstructured":"Gross WL, Hauschild S, Mistry N. The clinical relevance of ANCA in vasculitis. Clin Exp Immunol 1993; 93 (suppl 1): 7-11."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1016\/0140-6736(91)92694-W","article-title":"Antineutrophil cytoplasmic antibodies, cystic fibrosis, and infection","volume":"337","author":"Efthimou, J.; Spickett, G.; Lane, D.; Thompson, A.","year":"1991","unstructured":"Efthimou J, Spickett G, Lane D, Thompson A. Antineutrophil cytoplasmic antibodies, cystic fibrosis, and infection. (letter) Lancet 1991; 337: 1037-8.","journal-title":"(letter) Lancet"},{"key":"ref_7","first-page":"22","article-title":"An association between ANCA-positive renal disease and malignancy","volume":"40","author":"Edgar, J.D.M.; Rooney, D.P.; McNamee, P.; McNeill, T.A.","year":"1993","unstructured":"Edgar JDM, Rooney DP, McNamee P, McNeill TA. An association between ANCA-positive renal disease and malignancy. Clin Nephrol 1993; 40: 22-5.","journal-title":"Clin Nephrol"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/S0091-6749(05)80067-3","article-title":"A distinct subset of antineutrophil cytoplasmic antibodies is associated with inflammatory bowel disease","volume":"86","author":"Saxon, A.; Shanahan, F.; Landers, C.","year":"1990","unstructured":"Saxon A, Shanahan F, Landers C, et al. A distinct subset of antineutrophil cytoplasmic antibodies is associated with inflammatory bowel disease. J Allergy Clin Immunol 1990; 86: 202-10.","journal-title":"J Allergy Clin Immunol"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/S0171-2985(11)80509-7","article-title":"A new type of perinuclear anti-neutrophil cytoplasmic antibody (pANCA) in active ulcerative colitis but not in Crohn's disease","volume":"181","author":"Rump, J.A.; Scholmerich, J.; Gross, V.","year":"1990","unstructured":"Rump JA, Scholmerich J, Gross V, et al. A new type of perinuclear anti-neutrophil cytoplasmic antibody (pANCA) in active ulcerative colitis but not in Crohn's disease. Immunobiology 1990; 181: 406-13.","journal-title":"Immunobiology"},{"key":"ref_10","first-page":"255","article-title":"Autoantibodies to neutrophil cytoplasmic enzymes in Felty's syndrome","volume":"93","author":"Coremans, I.E.M.; Hagen, E.C.; Daha, M.R.; van der Woude, F.J.; van der Voort; Breedfeld, F.C.","year":"1993","unstructured":"Coremans IEM, Hagen EC, Daha MR, van der Woude FJ, van der Voort, Breedfeld FC. Autoantibodies to neutrophil cytoplasmic enzymes in Felty's syndrome. Clin Exp Immunol 1993; 93: 255-62.","journal-title":"Clin Exp Immunol"},{"key":"ref_11","first-page":"12","article-title":"Delineation of a standard procedure for indirect immunofluorescent detection of ANCA","volume":"97","author":"Wiik, A.","year":"1989","unstructured":"Wiik A. Delineation of a standard procedure for indirect immunofluorescent detection of ANCA. Acta Pathol Microbiol Immunol Scand 1989; 97 (suppl): 12-3.","journal-title":"Acta Pathol Microbiol Immunol Scand"},{"key":"ref_12","first-page":"4115","article-title":"Antineutrophil cytoplasmic autoantibodies induce neutrophils to degranulate and produce oxygen","volume-title":"radicals in vitro. Proc Natl Acad Sci","volume":"87","author":"Falk, R.J.; Terrell, R.S.; Charles, L.A.; Jennette, J.C.","year":"1990","unstructured":"Falk RJ, Terrell RS, Charles LA, Jennette JC. Antineutrophil cytoplasmic autoantibodies induce neutrophils to degranulate and produce oxygen radicals in vitro. Proc Natl Acad Sci USA 1990; 87: 4115-9."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/S0272-6386(12)80879-1","article-title":"The pathogenic role of antineutrophil cytoplasmic autoantibodies","volume":"18","author":"Ewart, B.H.; Jennette, J.C.; Falk, R.J.","year":"1991","unstructured":"Ewart BH, Jennette JC, Falk RJ. The pathogenic role of antineutrophil cytoplasmic autoantibodies. AmJ Kidney Dis 1991; 18: 188-95.","journal-title":"AmJ Kidney Dis"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1007\/BF01649318","article-title":"Antineutrophil cytoplasmic autoantibodies: immunobiological aspects","volume":"69","author":"Gross, W.L.; Csernok, E.; Schmitt, W.H.","year":"1991","unstructured":"Gross WL, Csernok E, Schmitt WH. Antineutrophil cytoplasmic autoantibodies: immunobiological aspects. Klin Wochenschr 1991; 69: 558-66.","journal-title":"Klin Wochenschr"},{"key":"ref_15","first-page":"493","article-title":"Cardiac and vascular diseases","volume-title":"clinical immunology","author":"Cupps, T.R.","year":"1991","unstructured":"Cupps TR. Cardiac and vascular diseases. In: Stites DP, Terr AI, eds. Basic and clinical immunology 7th edn. Connecticut: Appleton and Lange, 1991; pp 493-505.","edition":"7th edn"},{"key":"ref_16","first-page":"966","article-title":"Use of predictive value theory in clinical immunology","volume-title":"of clinical laboratory immunology","author":"Gallen, R.S.","year":"1986","unstructured":"Gallen RS. Use of predictive value theory in clinical immunology. In: Rose NR, Friedman H, Fahey JL, eds. Manual of clinical laboratory immunology 3rd edn. Washington: American Society of Microbiology, 1986; pp 966-71.","edition":"3rd edn"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1093\/rheumatology\/31.3.185","article-title":"Antinuclear and antineutrophil cytoplasmic antibodies (ANCA) in the sera of patients with Felty's syndrome","volume":"31","author":"Juby, C.; Johnston, C.; Davis, P.; Russell, A.S.","year":"1992","unstructured":"Juby C, Johnston C, Davis P, Russell AS. 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(letter) Br J Rheumatol 1992; 31: 859-60.","journal-title":"(letter) Br J Rheumatol"},{"issue":"1","key":"ref_19","first-page":"33","article-title":"Anti-neutrophil cytoplasmic antibodies (ANCA) and extraarticular involvement in rheumatoid arthritis (RA)","volume":"93","author":"Braun, M.G.; Csernok, E.; Schmitt, W.; Hauschild, S.; Gross, W.L.","year":"1993","unstructured":"Braun MG, Csernok E, Schmitt W, Hauschild S, Gross WL. Anti-neutrophil cytoplasmic antibodies (ANCA) and extraarticular involvement in rheumatoid arthritis (RA). (abstract) Clin Exp Immunol 1993; 93 (suppl 1): 33.","journal-title":"(abstract) Clin Exp Immunol"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1016\/0140-6736(91)93102-F","article-title":"ANCA and infection","volume":"337","author":"Schmitt, W.H.; Csernok, E.; Gross, W.L.","year":"1991","unstructured":"Schmitt WH, Csernok E, Gross WL. ANCA and infection. (letter) Lancet 1991; 337: 1416-7.","journal-title":"(letter) Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1136\/ard.49.10.741","article-title":"The ANCA test: its clinical relevance","volume":"49","author":"Ramirez, G.; Khamashta, M.A.; Hughes, G.R.V.","year":"1990","unstructured":"Ramirez G, Khamashta MA, Hughes GRV. The ANCA test: its clinical relevance. Ann Rheum Dis 1990; 49: 741-2.","journal-title":"Ann Rheum Dis"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1136\/bmj.309.6953.513","article-title":"Auditing audits: use and development of the Oxfordshire Medical Advisory Group rating system","volume":"309","author":"Lawrence, M.; Griew, K.; Derry, J.; Anderson, J.; Humphreys, J.","year":"1994","unstructured":"Lawrence M, Griew K, Derry J, Anderson J, Humphreys J. Auditing audits: use and development of the Oxfordshire Medical Advisory Group rating system. BMJ 1994; 309: 513-6.","journal-title":"BMJ"},{"key":"ref_23","first-page":"291","article-title":"Clinical significance of anti-neutrophil cytoplasm antibodies detected by a standardised indirect immunofluorescence assay","volume":"87","author":"Davenport, A.; Lock, R.J.; Wallington, T.B.; Feest, T.G.","year":"1994","unstructured":"Davenport A, Lock RJ, Wallington TB, Feest TG. Clinical significance of anti-neutrophil cytoplasm antibodies detected by a standardised indirect immunofluorescence assay. QJ Med 1994; 87: 291-9.","journal-title":"QJ Med"},{"key":"ref_24","first-page":"135","article-title":"Use of an ELISA system to detect antimyeloperoxidase autoantibodies in systemic vasculitis","volume":"22","author":"Edgar, J.D.M.; Cooper, M.; Conlan, S.K.; McMillan, S.A.; McNeill, T.A.","year":"1992","unstructured":"Edgar JDM, Cooper M, Conlan SK, McMillan SA, McNeill TA. Use of an ELISA system to detect antimyeloperoxidase autoantibodies in systemic vasculitis. (abstract) Clin Exp Allergy 1992; 22: 135.","journal-title":"(abstract) Clin Exp Allergy"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/71\/840\/605\/50219076\/postgradmedj-71-605.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/71\/840\/605\/50219076\/postgradmedj-71-605.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T01:14:17Z","timestamp":1683767657000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/71\/840\/605\/7044038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,10,1]]},"references-count":24,"journal-issue":{"issue":"840","published-online":{"date-parts":[[1995,10,1]]},"published-print":{"date-parts":[[1995,10,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.71.840.605","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1995,10]]},"published":{"date-parts":[[1995,10,1]]}}}