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Vasculitis
Prompt recognition of vasculitis either as a new presentation or a clinical relapse is key to optimizing management and preventing organ damage. 1
The good news is that prompt diagnosis and treatment with immunosuppressive therapy, such as cyclophosphamide, corticosteroids, and methotrexate, can help patients mitigate this organ damage.2
For several decades, Anti-Neutrophil Cytoplasmic Antibodies (ANCAs) have been recognized as an important laboratory tool in the diagnosis of the small-vessel vasculitis. International guidelines recommend utilizing serology for ANCAs. These diagnostic tools can help you identify the disease and start your patients on the road to treatment for granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA).3
Clinical and laboratory assessments are very important to provide a full picture of the disease and assist in identifying the specific type of vasculitis. Laboratory and imaging studies are essential in helping to confirm a clinical diagnosis but are of limited value in the absence of clinical signs when considering a diagnosis of systemic vasculitis.1
Who Should Be tested for Vasculitis?
Healthcare professionals should consider testing for ANCA in patients with the following clinical indications:3,4
- Chronic destructive upper airway disease
- Pulmonary nodules
- Renal and pulmonary inflammatory disease
- Rapidly progressive glomerulonephritis
- Skin vasculitis with systemic illness
- Mononeuritis multiplex
- Subglottic stenosis of the trachea
- Retro-orbital mass
Clinical guidelines recommend considering ANCA-associated vasculitis when inflammatory disease cannot be ascribed to any other disease and inflammation progresses despite antibiotics.
Testing Opportunities for Vasculitis
The revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis proposes that high-quality immunoassays for MPO and PR3 antibodies should be used as the primary screening method for patients suspected of having the ANCA-associated vaculitides GPA and MPA without the need for indirect immunofluorescence (IIF).3 It is worth noting that while MPO levels often decline following successful treatment of MPA, specific guidelines for this clinical purpose are not available.
EliA™ PR3S and EliA MPOS can quickly and accurately provide you with essential diagnostic and prognostic information that can help you identify and treat ANCA-associated vasculitis earlier in your patient’s journey.
EliA PR3S 5
PR ANCA=proteinase 3 antineutrophil cytoplasmic antibodies.
Sample material: Serum, plasma (EDTA, citrate, heparin)
Reference Values
| Measuring range: 0.2–177 IU/mL |
||
| Value | Classification | Comment |
| <2.0 IU/ml | Negative | |
| 2.0-3.0 IU/ml | Equivocal | For patients with equivocal results, it is recommended to retest after 8-12 weeks. |
| >3.0 IU/ml | Positive | |
EliA MPOS 6
Sample material: Serum, plasma (EDTA, citrate, heparin)
Reference Values
| Measuring range: 0.2–134 IU/mL |
||
| Value | Classification | Comment |
| <3.5 IU/ml | Negative | |
| 3.5-5.0 IU/ml | Equivocal | For patients with equivocal results, it is recommended to retest after 8-12 weeks. |
| >5.0 IU/ml | Positive | |
EliA GBM7
Sample material: Serum, plasma
Reference Values
| Measuring range: 0.8–680 IU/mL |
||
| Value | Classification | Comment |
| < 7 IU/ml | Negative | |
| 7-10 IU/ml | Equivocal | For patients with equivocal results, it is recommended to retest after 8-12 weeks. |
| >10 IU/ml | Positive | |
Reference values apply to all ages. Reference values, coating, dilution and sample material have been taken from respective Phadia™ 250 instrument Directions for Use. These data are intended as a guide and should be treated accordingly.
If you have any questions or uncertainty please contact us >
- Ntatsaki E, Carruthers D, Chakravarty K, et al. BSR and BHPR guideline for the management of adults with ANCA-associated vasculitis. Rheumatology (Oxford). 2014;53(12):2306-9.
- Watts RA, Dharmapalaiah C. ANCA-associated vasculitis. Arthritis Research UK. Reports on Rheumatic Diseases: Topical reviews. 2012. http://www.arthritisresearchuk.org/health-professionals-and-students/reports/topical-reviews/topical-reviews-autumn-2012.aspx. Accessed November 2017.
- Bossuyt X, Cohen Tervaert J-W, Arimura Y, et al. Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis. Nature Rev Rheumatol. 2017;doi:10.1038/nrrheum.2017.140
- Savige J, et al. International Consensus Statement on Testing and Reporting of Antineutrophil Cytoplasmic Antibodies (ANCA). Am J Clin Pathol. 1999 Apr;111(4):507-13.
- Phadia™ EliA™ PR3S Directions for Use for the Phadia 250 Laboratory System. Issued April 2017.
- EliA™ MPOS Directions for Use for the Phadia 250 Laboratory System. Issued April 2017.
- EliA™ GBM Directions for Use for the Phadia 250 Laboratory System. Issued March2017.
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