title: [Paradigm shift in ANCA diagnostics : New international consensus recommendations].
abstract: BACKGROUND
  Up to now indirect immunofluorescence (IIF) followed by an antigen-specific assay specific for proteinase 3 (PR3) or myeloperoxidase (MPO) has been the standard method for the detection of antineutrophil cytoplasmic antibodies (ANCA). The development of more sensitive and highly specific PR3-ANCA and MPO-ANCA immunoassays for the diagnosis of ANCA-associated vasculitis (AAV) has raised doubts about the two-stage diagnostic strategy currently recommended for ANCA detection.
  
  
  OBJECTIVE
  Presentation and discussion of the new international consensus recommendations on ANCA testing in AAV.
  
  
  METHODS
  This article presents the new guidelines for ANCA testing that have been developed based on the results of a recent large multicenter study by the European Vasculitis Society (EUVAS). The draft of the author committee was revised by each contributor and subsequently distributed to 12 experts on 4 continents. After further revision the final document was returned for ratification and submitted for publication.
  
  
  CONCLUSIONS
  The current study results confirm the superiority of the diagnostic value of antigen-specific immunoassays compared to IIF. The current consensus recommendations support the primary use of PR3-ANCA and MPO-ANCA immunoassays for diagnostic evaluation of patients with AAV without the categorical need for additional IIF.
authors.affiliation: Referenzlabor für Vaskulitis-Immundiagnostik, Vaskulitiszentrum Süd, Klinik für Innere Medizin, Rheumatologie und Immunologie, Kreiskliniken Esslingen gGmbH, Klinik Kirchheim, Akademisches Lehrkrankenhaus der Universität Tübingen, Eugenstr. 3, 73230, Kirchheim unter Teck, Deutschland. e.csernok@kk-es.de.
authors.forename: E
authors.initials: E
authors.lastname: Csernok
authors.affiliation: Referenzlabor für Vaskulitis-Immundiagnostik, Vaskulitiszentrum Süd, Klinik für Innere Medizin, Rheumatologie und Immunologie, Kreiskliniken Esslingen gGmbH, Klinik Kirchheim, Akademisches Lehrkrankenhaus der Universität Tübingen, Eugenstr. 3, 73230, Kirchheim unter Teck, Deutschland.
authors.forename: N
authors.initials: N
authors.lastname: Kempiners
authors.affiliation: Referenzlabor für Vaskulitis-Immundiagnostik, Vaskulitiszentrum Süd, Klinik für Innere Medizin, Rheumatologie und Immunologie, Kreiskliniken Esslingen gGmbH, Klinik Kirchheim, Akademisches Lehrkrankenhaus der Universität Tübingen, Eugenstr. 3, 73230, Kirchheim unter Teck, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Hellmich
mesh_terms: D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D000066491:Clinical Decision-Making / Q000379:methods; D019317:Evidence-Based Medicine / Q000592:standards*; D005858:Germany; D006801:Humans; D007118:Immunoassay / Q000379:methods / Q000592:standards* / Q000639:trends; D017063:Outcome Assessment, Health Care / Q000592:standards; D017410:Practice Guidelines as Topic; D012219:Rheumatology / Q000592:standards* / Q000639:trends; D016896:Treatment Outcome
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D015415:Biomarkers
keywords: ANCA; Antigen specific Immunoassays; Consensus recommendation; Vasculitis