TY  - JOUR
T1  - Analyzing Antineutrophil Cytoplasmic Antibody Associated Conditions in a Large, Random Sample of Patients: A Comparison of Enzyme-Linked Immunosorbent Assay and Indirect Immunofluorescence Tests
TT  - Geniş ve Rastgele Bir Örneklemde Antinötrofil Sitoplazmik Antikor İlişkili Durumların İncelenmesi: Enzyme-Linked ImmunoSorbent Assay ve İndirekt İmmunfloresan Testlerinin Karşılaştırılması
AU  - Salman, Emrah
AU  - Dinç, Bedia
PY  - 2025
DA  - August
Y2  - 2025
DO  - 10.18678/dtfd.1642806
JF  - Duzce Medical Journal
JO  - Duzce Med J
PB  - Duzce University
WT  - DergiPark
SN  - 1307-671X
SP  - 158
EP  - 164
VL  - 27
IS  - 2
LA  - en
AB  - Aim: The aim of this study was to examine the prevalence of antineutrophil cytoplasmic antibodies (ANCA) in a diverse group of Turkish patients admitted to a tertiary care hospital, their clinical characteristics, and ANCA test results.Material and Methods: This retrospective study analyzed 10,726 serum samples tested for ANCA over 4.5 years. All patients requested ANCA indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA) tests were included.Results: IIF/ELISA test results were positive for 973 (9.1%) patients, 875 IIF positive and 98 ELISA positive with negative IIF. Of the 875 IIF-positive patients, the p-ANCA pattern was observed in 631 (72.1%), and the c-ANCA pattern was observed in 222 (25.4%). MPO ELISA was positive in 16.6% (n=105), and PR3 ELISA was positive in 0.8% (n=5) of the p-ANCA positives, while MPO ELISA was positive in 0.9% (n=2), and PR3 ELISA was positive in 36.5% (n=81) of the c-ANCA positives. 11.6% (n=113) of the IIF/ELISA positives were ANCA-associated vasculitis (AAV). The ELISA test detected ANCA in 91 (80.5%) of the AAV patients. The positive predictive value (PPV) of IIF was 11.89%, while the PPV of the ELISA was 29.84%. The utilization of both IIF and ELISA resulted in a PPV of 41.75%.Conclusion: Antigen-specific immunoassays exhibit better diagnostic precision compared to IIF. Therefore, PR3- and MPO-ANCA ELISA are recommended for AAV screening. In patients with no suspicion of AAV, the more sensitive IIF test should be used. If IIF is positive, antigen-specific assays such as anti-MPO or anti-PR3 ELISA should confirm antigens.
KW  - Antineutrophil cytoplasmic antibody
KW  - indirect immunofluorescence assay
KW  - ELISA
N2  - Amaç: Bu çalışmanın amacı, Türkiye'nin çeşitli bölgelerinden üçüncü basamak bir hastaneye başvuran farklı hasta gruplarında antinötrofil sitoplazmik antikor (ANCA) prevalansını, klinik özelliklerini ve ANCA test sonuçlarını incelemektir.Gereç ve Yöntemler: Bu geriye dönük çalışmada, 4,5 yıl boyunca ANCA açısından test edilen 10.726 serum örneği analiz edildi. ANCA indirekt immünofloresan (IIF) ve enzyme-linked immunosorbent assay (ELISA) testleri talep edilen tüm hastalar çalışmaya dahil edildi.Bulgular: IIF/ELISA test sonuçları 973 (%9,1) hastada pozitifti, 875 IIF pozitif ve 98 ELISA pozitif ancak IIF negatifti. IIF pozitif 875 hastanın 631'inde (%72,1) p-ANCA paterni, 222'sinde (%25,4) c-ANCA paterni gözlendi. p-ANCA pozitiflerin %16,6'sında (n=105) MPO ELISA pozitif ve %0,8'inde (n=5) PR3 ELISA pozitif iken, c-ANCA pozitiflerin ise %0,9'unda (n=2) MPO ELISA pozitif ve %36,5'inde (n=81) PR3 ELISA pozitifti. IIF/ELISA pozitiflerin %11,6'sı (n=113) ANCA ilişkili vaskülit (AAV) idi. ELISA testi, AAV hastalarının 91'inde (%80,5) ANCA tespit etti. IIF'nin pozitif prediktif değeri (PPV) %11,89 iken, ELISA'nın pozitif prediktif değeri %29,84 olarak bulundu. Hem IIF hem de ELISA kullanımı %41,75'lik bir PPV ile sonuçlandı.Sonuç: Antijene özgü immünoassayler, IIF'ye kıyasla daha iyi tanısal kesinlik sergilemektedir. Bu nedenle, AAV taraması için PR3- ve MPO-ANCA ELISA önerilmektedir. AAV şüphesi olmayan hastalarda, daha hassas olan IIF testi kullanılmalıdır. IIF pozitifse, anti-MPO veya anti-PR3 ELISA gibi antijene özgü testler antijenleri doğrulamalıdır.
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UR  - https://doi.org/10.18678/dtfd.1642806
L1  - https://dergipark.org.tr/en/download/article-file/4622803
ER  -