title: Variability in Testing for Antineutrophil Cytoplasmic Antibodies: A Survey of Participants in the College of American Pathologists Proficiency Testing Program.
abstract: BACKGROUND
  -Variability in testing for antineutrophil cytoplasmic antibodies (ANCAs) contributes to confusion and controversy related to testing for vasculitis and other ANCA-associated diseases.
  
  
  OBJECTIVE
  -To survey laboratory testing practices regarding ANCA testing and to investigate differences in testing algorithms.
  
  
  METHODS
  -Supplemental questions were sent to the 333 laboratories participating in the College of American Pathologists proficiency testing program for ANCA as part of the Special Immunology S2 Survey.
  
  
  RESULTS
  -A total of 315 laboratories submitted responses to the supplemental questions. Only 88 of 315 participants (28%) reported using a combination of indirect immunofluorescence (IFA) and enzyme immunoassay (EIA) techniques as recommended by current guidelines, with a few additional labs using IFA and multiplex bead assay as an acceptable alternative to EIA. Other labs reported using only IFA, EIA, or multiplex bead assays.
  
  
  CONCLUSIONS
  -A wide variety of testing algorithms are in use for ANCA testing despite evidence to suggest that a combination of IFA and EIA testing provides the most comprehensive information. Laboratories should inform clinicians clearly about testing practices and utility of testing in specific disease states.
authors.affiliation: From the Department of Laboratory Medicine, University of California, San Francisco (Dr Karlon); Quest Diagnostics Nichols Institute, San Juan Capistrano, California (Dr Naides); the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (Dr Crosson); and the Department of Clinical Pathology, Cleveland Clinic, Cleveland, Ohio (Dr Ansari).
authors.forename: William J
authors.initials: WJ
authors.lastname: Karlon
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Naides
authors.forename: John T
authors.initials: JT
authors.lastname: Crosson
authors.forename: Mohammad Qasim
authors.initials: MQ
authors.lastname: Ansari
mesh_terms: D000465:Algorithms; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D006801:Humans; D007753:Laboratories / Q000592:standards*; D059021:Laboratory Proficiency Testing; D010338:Pathology, Clinical / Q000592:standards*; D012680:Sensitivity and Specificity; D014481:United States; D014657:Vasculitis / Q000175:diagnosis* / Q000276:immunology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic