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Interassay and Interobserver Variability in the Detection of Anti-neutrophil Cytoplasmic Antibodies in Patients with Ulcerative Colitis

¹ Department of Gastroenterology and² Laboratory Medicine, University Hospital Gasthuisberg, KULeuven, Leuven, Belgium;³ Department of Gastroenterology and⁴ Immunology Laboratory, Ospedale Mauriziano Umberto I, Torino, Italy;⁵ INOVA Diagnostics Inc., San Diego, CA;⁶ Center for Statistics, Limburgs Universitair Centrum, Diepenbeek, Belgium;⁷ Harvard School of Public Health, Department of Biostatistics, Boston, MA;⁸ Department of Pathology, University of Iowa, Iowa City, IA

^aaddress correspondence to this author at: Laboratory Medicine, University Hospital Gasthuisberg, KULeuven, 3000 Leuven, Belgium; fax 32-16-347931, e-mail Xavier.Bossuyt@uz.kuleuven.ac.be

The first 300 words of the full text of this article appear below.

Inflammatory bowel disease (IBD) represents a spectrum of disorders that affect the gastrointestinal tract (1). IBD includes two major entities, Crohn disease and ulcerative colitis (UC). Although the etiology of IBD is unknown at present, it is believed to be an immunologically mediated disease (2). Over the last 40 years, various (auto)antibodies have been described in IBD (3). Anti-Saccharomyces cerevisiae antibodies (4) and perinuclear anti-neutrophil cytoplasmic antibodies (pANCAs) (5) have relatively high prevalence in patients with Crohn disease and UC, respectively. Unlike ANCAs present in vasculitis (6) and in Wegener granulomatosis (7), the exact target antigen of UC-associated pANCAs has not been identified (5)(8).

As a consequence, immunofluorescence microscopy is the only widely available technique for screening for these antibodies. Commercially available substrates, however, are not standardized, and part of the discrepancy in results could be attributable to differences among the substrates/assays used, as reported recently (9). Moreover, because specific microscopic criteria to distinguish UC-associated pANCAs from pANCAs seen in vasculitis vary among laboratories, discrepant results could also be attributable to an investigator’s interpretation of the fluorescence pattern.

Despite these methodologic problems, it has been suggested that the determination of pANCAs in UC could serve as an adjunct to conventional tools in the diagnosis of IBD and could be used for better phenotypic classification of the disease. Therefore, pANCA analysis is widely performed in the context of laboratory evaluation of IBD.

The aim of this study was to assess the interassay and interobserver variability in the detection of UC-associated ANCAs.

Sera obtained from 50 patients with UC (23 females and 27 males; mean age, 40.7 years; range, 19–75 years), defined according to the Lennard-Jones criteria (10), were . . . [Full Text of this Article]

The following articles in journals at HighWire Press have cited this article:

				X. Bossuyt Serologic Markers in Inflammatory Bowel Disease Clin. Chem., February 1, 2006; 52(2): 171 - 181. [Abstract] [Full Text] [PDF]