MEDICAL TESTS

FIGURE 5 - ANCA IN DIAGNOSING SMALL VESSEL AV

Approx. Cost/100
Roche Chemstrip 9 $60 (Nine tests)
Bayer Hema-CombiStix $60 (Blood, protein, glucose, pH)
Bayer Uristix 4 $24 (Protein, leukocytes, glucose, nitrate)
Permaxim URS5 $15 (Blood, protein, glucose, pH, ketones)
TABLE 2 - POSITIVE ANTI-PR3 OR ANTI-MPO IN SOME AVs 
Approximate % pos ANCA
Approximate % of patients demonstrating


Combined
patterns
C- Pattern
P-Pattern
Wegener's granulomatosis Note 1 Active generalized
85-92
85-90
2-5
  Limited forms
60-67
85-90
2-5
  Inactive
30-35
85-90
2-5
Microscopic polyangiitis (MPA) Note 1
    
    
75
Idiopathic Crescentic Glomerulonephritis Note 1
80
some*
majority*
Polyarteritis Nodosa Note 1
50
86
14
Churg-Strauss Note 1
50
80
20
Systemic lupus erythematosus (SLE) Note 1
<10
0
>90
Rheumatoid arthritis Note 1
<5
0
>90
Sjogren's syndrome Note 1
25
0
>90
Ulcerative colitis Note 2
0
0
50 (Note 3)
Henoch-Shoenlein purpura (HSP) Note 2
0
0
0
Takayasu's arthritis (TAK) Note 2
0
0
0
     

Kawasaki disease Note 2
0
0
0
* No quantitation in the literature
Note 1 - Figures from http://www.aruplab.com/guides/ug/tests/0050523.jsp - National Standards Lab
Note 2 - Approximation of the proportion of patients positive for ANCA based on references cited by Kallenberg et al (9) and others
Note 3 - Figures from a paper by Stegleman et al.  Clinically, skin vasculitis and arthralgias predominated and renal vasculitis was rare. 

TABLE 3 - ANCA - ANTIGEN TARGETS & AI DISEASES

IMMUNOFLUORESCENCE PATTERN ANCA TARGET ANTIGEN ASSOCIATED DISEASE
C-ANCA PR3 WG
P-ANCA MPO MPA, CSS
P-ANCA HLE UC, CD, PSC, SLE
P-ANCA alpha-enolase  
P-ANCA catalase  
P-ANCA azurodicin (AZ)  
P-ANCA (atypical) lactoferrin (LF) UC, CD, PSC
P-ANCA (atypical) cathepsin G (CG) UC, CD, PSC, SLE, RA
P-ANCA (atypical) lysozyme (LZ) UC, CD, PSC
C-ANCA, P-ANCA (atypical) actin AIH
C-ANCA, P-ANCA (atypical) BPI UC, CD, PSC, AIH, SLE
P-ANCA (atypical) HMG1/2 UC, SLE, RA
P-ANCA (atypical) lamine B1 UC, CD, SLE
P-ANCA (atypical) histone H1 UC
P-ANCA (atypical) 50 Kd UC, AIH
WG-Wegener's granulomatosis; MPA-microscopic polyangiitis; CSS-Churg-Strauss syndrome; UC-ulcerative colitis; CD-Crohn's disease; PSC-primary sclerosing cholangitis; SLE-systemic lupus erythematosus; RA-rheumatoid arthritis; AIH-autoimmune hepatitis; HLE--human leukocyte elastase; BPI-bactericidal/permeability-increasing protein; HMG1/2-high mobility group of non-histone chromosomal proteins 1 and 2

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