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Audit of the clinical usefulness of a rapid qualitative ELISA screen for antimyeloperoxidase and antiproteinase 3 antibodies in the assessment of patients with suspected vasculitis
  1. A Aslam,
  2. T L Newman,
  3. S A Misbah
  1. Department of Clinical Immunology, John Radcliffe Hospital, Oxford OX3 9DU, UK
 Correspondence to:
 Dr A Aslam, Department of Clinical Immunology, John Radcliffe Hospital, Oxford OX3 9DU, UK;


Background: The need for urgent antineutrophil cytoplasmic antibody (ANCA) results when assessing patients with acute renal failure, pulmonary renal syndrome, or mononeuritis multiplex has led to the development of a rapid qualitative ELISA screening assay for antibodies to myeloperoxidase (MPO) and proteinase 3 (PR3).

Aims: To report the use of a rapid qualitative ELISA screen for PR3-ANCA and MPO-ANCA in a regional immunology laboratory and its correlation with standard indirect immunofluorescence (IIF) and quantitative ELISA for PR3-ANCA and MPO-ANCA.

Methods: Over 12 months, 103 samples requiring urgent ANCA testing were screened by a rapid qualitative ELISA and the results compared with IIF and quantitative ELISA assays for PR3-ANCA and MPO-ANCA.

Results: There was an excellent correlation between the rapid qualitative ELISA and standard ANCA IIF and a routine ELISA for MPO/PR3-ANCA, with sensitivities ranging from 82% to 100%. There were two false negatives, which gave weak to moderately positive values as determined by routine ELISA. However, the clinical relevance of these two cases is doubtful.

Conclusions: The rapid ELISA for anti-MPO and anti-PR3 correlates well with quantitative ELISA and IIF ANCA, and urgent management decisions in patients with suspected small vessel vasculitis can be based with confidence on this test.

  • antineutrophil cytoplasmic antibodies
  • antimyeloperoxidase antibodies
  • antiproteinase 3 antibodies
  • vasculitis
  • enzyme linked immunosorbent assay
  • ANCA, antineutrophil cytoplasmic antibodies
  • ELISA, enzyme linked immunosorbent assay
  • IIF, indirect immunofluorescence
  • MPO, myeloperoxidase
  • OD, optical density
  • PR3, proteinase 3

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