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Appropriateness of antineutrophil cytoplasmic antibody testing in a tertiary hospital
  1. P C Robinson1,
  2. R H Steele2
  1. 1
    Rheumatology Department, Hutt Hospital, Lower Hutt, Wellington, New Zealand
  2. 2
    Immunology Department, Wellington Hospital, Wellington South, New Zealand
  1. Dr P Robinson, Rheumatology Department, Hutt Hospital, Private Bag 31907, Lower Hutt, Wellington, New Zealand; philip.robinson{at}


Aims: 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.

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  • Competing interests: None.