An international survey on anti-neutrophil cytoplasmic antibodies (ANCA) testing in daily clinical practice

Jan Damoiseaux*, Ingmar Heijnen, Christel Van Campenhout, Catharina Eriksson, Nicole Fabien, Manfred Herold, Renate G. Van Der Molen, William Egner, Dina Patel, Aresio Plaza-Lopez, Antonella Radice, Marie José Rego De Sousa, Markku Viander, Yehuda Shoenfeld

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Detection of anti-neutrophil cytoplasmic antibodies (ANCA) is important for the diagnosis of the ANCA-associated vasculitides (AAV). For AAV, especially ANCA directed against myeloperoxidase (MPO) and proteinase 3 (PR3) are most relevant. ANCA with less well-defined specificities may, however, also be detected in other inflammatory and non-inflammatory conditions. A questionnaire, initiated by the European Autoimmunity Standardisation Initiative (EASI), was used to gather information on methods and testing algorithms used for ANCA in clinical laboratories of 12 European countries (EASI survey). Four hundred and twenty-nine responses were included in the EASI survey analysis which revealed differences within countries and between countries. Laboratories overall were poor in adherence to international consensus on ANCA testing. Substantial variation was observed with respect to the use of ANCA indirect immunofluorescence (IIF) in the algorithm, application of distinct methods for MPO- and PR3-ANCA, the daily availability of new ANCA results, and interpretation of test results. Awareness of these differences may stimulate further harmonization and standardization of ANCA testing. This may be promoted by an update of the international ANCA consensus and the introduction of international standards.

Original languageEnglish
Pages (from-to)1759-1770
Number of pages12
JournalClinical Chemistry and Laboratory Medicine
Issue number10
StatePublished - 25 Sep 2018
Externally publishedYes


  • ANCA
  • myeloperoxidase
  • proteinase-3
  • testing algorithm
  • vasculitis


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