PMID- 26016753
OWN - NLM
STAT- MEDLINE
DCOM- 20150806
LR  - 20170112
IS  - 0392-856X (Print)
IS  - 0392-856X (Linking)
VI  - 33
IP  - 2 Suppl 89
DP  - 2015 Mar-Apr
TI  - There is no benefit in routinely monitoring ANCA titres in patients with 
      granulomatosis with polyangiitis.
PG  - S-72-6
AB  - OBJECTIVES: To analyse the link between antineutrophil cytoplasmic antibody 
      (ANCA) levels and risk of relapse in patients with granulomatosis with 
      polyangiitis (GPA), as the clinical benefit of monitoring ANCA levels is 
      uncertain. METHODS: A retrospective analysis was made of all charts available 
      from 43 patients diagnosed with GPA, fulfilling The American College of 
      Rheumatology 1990 criteria, and followed between 1994 and 2012 at a general 
      internal medicine department of a university hospital. Clinical and biochemical 
      data (i.e. anti-proteinase 3 (PR3) levels) were collected and correlated. 
      RESULTS: 43 relapses occurred in 25 patients (58.1% of 43 patients). When blood 
      samples are routinely taken at a follow-up visit (i.e. low pre-test probability, 
      +/- 5.5%) in the GPA-population, a 75%-increase in the PR3-level or its 
      reappearance has only limited positive predictive value (PPV 15.0% and 22.5% 
      respectively) for predicting relapse. Adversely, when clinical suspicion of 
      relapse is high (i.e. high pre-test probability, for example 50%), an increase of 
      75% or reappearance of PR3 makes relapse even more likely (PPV 77.5%, 81.6% 
      respectively). Conversely, a high negative predictive value (NPV) of 99.3% and a 
      negative likelihood ratio (LR-) of 0.12 suggest that, in the absence of PR3, 
      relapse is unlikely if patients had detectable ANCAs at diagnosis. CONCLUSIONS: 
      Routine ANCA monitoring in patients diagnosed with GPA has limited value. 
      However, targeted determination of ANCA levels may be useful if a relapse is 
      clinically suspected (i.e. high pre-test probability).
FAU - Verstockt, B
AU  - Verstockt B
AD  - University Hospitals Leuven, Leuven, Belgium.
FAU - Bossuyt, X
AU  - Bossuyt X
AD  - Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, 
      Belgium.
FAU - Vanderschueren, S
AU  - Vanderschueren S
AD  - Clinical Department of General Internal Medicine Department, Research Department 
      of Microbiology and Immunology, Laboratory of Clinical Infectious and 
      Inflammatory Disorders, University Hospitals Leuven, Leuven, Belgium.
FAU - Blockmans, D
AU  - Blockmans D
AD  - Clinical Department of General Internal Medicine Department, Research Department 
      of Microbiology and Immunology, Laboratory of Clinical Infectious and 
      Inflammatory Disorders, University Hospitals Leuven, Leuven, Belgium.
LA  - eng
PT  - Journal Article
DEP - 20150526
PL  - Italy
TA  - Clin Exp Rheumatol
JT  - Clinical and experimental rheumatology
JID - 8308521
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - EC 3.4.21.76 (Myeloblastin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antibodies, Antineutrophil Cytoplasmic/*immunology
MH  - Cohort Studies
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Female
MH  - Granulomatosis with Polyangiitis/*immunology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myeloblastin/*immunology
MH  - Prognosis
MH  - Recurrence
MH  - Retrospective Studies
EDAT- 2015/05/29 06:00
MHDA- 2015/08/08 06:00
CRDT- 2015/05/29 06:00
PHST- 2014/09/27 00:00 [received]
PHST- 2015/01/19 00:00 [accepted]
PHST- 2015/05/29 06:00 [entrez]
PHST- 2015/05/29 06:00 [pubmed]
PHST- 2015/08/08 06:00 [medline]
AID - 8704 [pii]
PST - ppublish
SO  - Clin Exp Rheumatol. 2015 Mar-Apr;33(2 Suppl 89):S-72-6. Epub 2015 May 26.