疑似血管炎患者抗核抗体对抗中性粒细胞胞浆抗体测定的干扰:一系列病例。

IF 3.8 3区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY
Biochemia Medica Pub Date : 2023-10-15 Epub Date: 2023-08-05 DOI:10.11613/BM.2023.031001
Mala Mahto, Neha Rai, Pulak Ranjan Das, Saurabh Karmakar, Divendu Bhushan
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引用次数: 0

摘要

抗中性粒细胞胞浆抗体(ANCA)主要与中小血管血管炎有关。目前可用于检测这些抗体的两种主要方法是间接免疫荧光(IIF)和单特异性蛋白酶3(PR3)以及基于髓过氧化物酶(MPO)的免疫测定。然而,关于实验室ANCA检测模式的明确指南仍然不存在,这导致了诊断和进一步的患者管理方面的问题。通过IIF和酶联免疫吸附试验(ELISA)进行的抗中性粒细胞细胞质抗体检测在血管炎以外的疾病和重叠的自身免疫条件下通常会带来重大挑战。IIF报告的抗中性粒细胞细胞质抗体在某些情况下可能具有挑战性。本病例系列旨在讨论四例IIF在ANCA检测过程中可能干扰抗核抗体(ANA)导致ANCA假阳性的病例。随后通过线免疫分析(LIA)对PR3、MPO和肾小球基底膜(GBM)抗原进行反射测试的所有四个病例都证明了相反的情况。在通过IIF分析ANCA的存在时,应牢记ANA可能干扰导致ANCA假阳性结果,并建议采用其他检测方法,如ELISA、用MPO和PR3包被的珠粒进行基于粒细胞的扩展IIF检测等。如果结果不明确,还应考虑血管炎以外疾病中非典型ANCA的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Interference of anti-nuclear antibodies on determination of anti-neutrophil cytoplasmic antibodies in patients suspected of vasculitis: a case series.

Interference of anti-nuclear antibodies on determination of anti-neutrophil cytoplasmic antibodies in patients suspected of vasculitis: a case series.

Interference of anti-nuclear antibodies on determination of anti-neutrophil cytoplasmic antibodies in patients suspected of vasculitis: a case series.

Interference of anti-nuclear antibodies on determination of anti-neutrophil cytoplasmic antibodies in patients suspected of vasculitis: a case series.

Anti-neutrophil cytoplasmic antibodies (ANCA) are mainly associated with medium and small vessel vasculitis. Two main methodologies currently available for detection of these antibodies are indirect immunofluorescence (IIF) and monospecific proteinase 3 (PR3) and myeloperoxidase (MPO) based immunoassays. However, well-defined guidelines regarding mode of testing for ANCA in laboratories still don't exist, leading to problems in diagnosis and further patient management. Anti-neutrophil cytoplasmic antibodies testing by IIF and enzyme linked immunosorbent assay (ELISA) often pose a significant challenge in diseases other than vasculitis and in overlapping autoimmune conditions. Anti-neutrophil cytoplasmic antibodies reporting by IIF can be challenging in certain circumstances. This case series aims to discuss four cases with probable interference of anti-nuclear antibodies (ANA) during ANCA testing by IIF resulting in ANCA false positivity. All four cases on subsequent reflex testing by line immunoassay (LIA) for PR3, MPO and glomerular basement membrane (GBM) antigens proved otherwise. While analysing for the presence of ANCA by IIF, the possible interference of ANA leading to a false positive ANCA result should be kept in mind and alternative methods of testing like ELISA, extended granulocyte based IIF assays with MPO and PR3 coated beads, etc., should also be advised. Probability of atypical ANCA in diseases other than vasculitis should also be considered in case of ambiguous results.

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来源期刊
Biochemia Medica
Biochemia Medica 医学-医学实验技术
CiteScore
5.50
自引率
3.00%
发文量
70
审稿时长
>12 weeks
期刊介绍: Biochemia Medica is the official peer-reviewed journal of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Journal provides a wide coverage of research in all aspects of clinical chemistry and laboratory medicine. Following categories fit into the scope of the Journal: general clinical chemistry, haematology and haemostasis, molecular diagnostics and endocrinology. Development, validation and verification of analytical techniques and methods applicable to clinical chemistry and laboratory medicine are welcome as well as studies dealing with laboratory organization, automation and quality control. Journal publishes on a regular basis educative preanalytical case reports (Preanalytical mysteries), articles dealing with applied biostatistics (Lessons in biostatistics) and research integrity (Research integrity corner).
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