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Rheumatology 2002; 41: 481-483
© 2002 British Society for Rheumatology

Editorial

Rational use of ANCA in the diagnosis of vasculitis

A. Wiik

Department of Autoimmunology, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S., Denmark

Antineutrophil cytoplasmic antibodies (ANCA) are autoantibodies that are specifically directed to multiple intracellular antigens in neutrophils and monocytes. Such neutrophil-specific autoantibodies have been assumed to exist since the early 1960s, when the indirect immunofluorescence (IIF) technique became popular as a screening method for demonstrating autoantibodies to tissue structures and cells. Intense interest in ANCA serology as a potential tool for diagnosing and monitoring disease activity in patients with Wegener's granulomatosis (WG) and necrotizing and crescentic glomerulonephritis (NCGN) arose in the 1980s. As the classical granular cytoplasmic ANCA (C-ANCA) seemed to be monospecific for the elastinolytic enzyme proteinase 3 (PR3) and the perinuclear ANCA (P-ANCA) appeared to be monospecific for the enzyme myeloperoxidase (MPO) in patients with primary small vessel vasculitides (SVV), it was assumed by some researchers that all neutrophil-specific autoantibodies were selectively directed to cytoplasmic granule constituents even in other ANCA-positive conditions, e.g. rheumatoid arthritis, Felty's syndrome and ulcerative . . . [Full Text of this Article]

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[Abstract] [Full Text] [PDF]