Appropriateness of antineutrophil cytoplasmic antibody testing in a tertiary hospital.
OBJECTIVE
To determine whether indications for ordering antineutrophil cytoplasmic antibodies (ANCA) meet the 1999 guidelines proposed for ANCA testing; and to examine the test characteristics of the ANCA test.


METHODS
The indications for all ANCA tests over a two-year period were assessed and compared to the 1999 guidelines for the appropriate testing of ANCA.


RESULTS
1127 tests were examined. Overall 33.4% had an indication meeting the 1999 guidelines. The commonest non-guideline indications were ocular or orbital inflammation, liver disease and inflammatory bowel disease. All tests with a positive ANCA had indications for testing in line with the 1999 guidelines. In all but one case an ANCA associated small vessel vasculitis (AASVV) was present.


CONCLUSIONS
ANCA is ordered for a wide range of guideline and non-guideline indications. No cases of AASVV would have been missed if ordering were restricted to tests meeting the 1999 guidelines.
Robinson
P C
PC
Rheumatology Department, Hutt Hospital, Private Bag 31907, Lower Hutt, Wellington, New Zealand. philip.robinson@huttvalleydhb.org.nz
Steele
R H
RH
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005189:False Positive Reactions; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D009520:New Zealand; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D014657:Vasculitis / Q000175:diagnosis*
D019268:Antibodies, Antineutrophil Cytoplasmic; D015415:Biomarkers