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neutrophil cytoplasmic antibody (ANCA) in CSF
Also see cANCA, pANCA & see ARUP consult [7]
Indications:
- evaluation of ANCA-associated vasculitis
- Wegener's granulomatosis
- microscopic polyangiitis
Reference interval:
- negative
- < 1:20
Clinical significance:
- useful test in patient's with Wegener's granulomatosis, related vasculitides & glomerular diseases
- perinuclear (pANCA) & cytoplasmic patterns (cANCA) are 2 patterns recognized by indirect immunofluorescence
- the cytoplasmic pattern (cANCA) is directed against myeloblastin (serine proteinase-3)
- the perinuclear pattern (pANCA) may be directed against myeloperoxidase or leukocyte elastase.
Associated factors: [6]
- genetic predisposition
- environmental triggers (silica exposure)
- infections (tuberculosis, HIV, hepatitis C, parvovirus B19, mycosis)
- neoplasia (lympohoma, myelodysplasia, monoclonal gammopathy)
- drugs (propythyouracil, cocaine, minocycline)
Specimen: store at -20 C
Methods:
- indirect immunofluorescence on fixed neutrophilic granules
- distinctive patterns perinuclear (an artifact of fixation) & cytoplasmic may be observed
- solid phase EIA's are in development
Related
anti-neutrophil cytoplasmic antibody (ANCA)
cerebrospinal fluid
neutrophil or polymorphonuclear leukocyte (PMN, poly)
General
neutrophil cytoplasmic antibody (ANCA) in body fluid
References
- Clinical Guide to Laboratory Tests, NW Tietz (ed) 3rd ed,
WB Saunders, Philadelphia 1995
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 782, 847
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 1913
- Kaiser Permanente Northern Calfornia Regional Laboratory
- Medical Knowledge Self Assessment Program (MKSAP) 11, 16.
American College of Physicians, Philadelphia 1998, 2012
- Bosch X et al,
Antineutrophil cytoplasmic antibodies.
Lancet 2006, 368:404
PMID: 16876669
- ARUP Consult:Systemic Vasculitis
https://arupconsult.com/content/vasculitis