Anti-neutrophil cytoplasm antibodies, anti-GBM antibodies and anti-dsDNA antibodies in glomerulonephritis

Eur J Clin Invest. 1992 Dec;22(12):783-92. doi: 10.1111/j.1365-2362.1992.tb01447.x.

Abstract

The diagnostic potential of assays detecting anti-neutrophil cytoplasm antibodies (ANCA), anti-GBM antibodies and anti-dsDNA antibodies was evaluated by examining sera from time of admission in a consecutive series of 455 patients with biopsy verified primary or secondary glomerulonephritis (GN). ANCA were classified into c- and p-ANCA by indirect immunofluorescence (IIF) and ELISAs using alfa-granule extract, proteinase-3, myeloperoxidase (MPO), elastase and lactoferrin. C-ANCA was virtually confined to 64 patients with systemic small vessel vasculitis, 66-74% being c-ANCA positive. P-ANCA against MPO, seen in 47 patients, segregated through many diagnostic categories of primary and secondary severe GN. ANCA against lactoferrin and elastase were rare. Anti-dsDNA positive patients constituted 57% of the 44 ANA-positive patients with systemic lupus erythematosus. It is concluded that the IIF and ELISAs for anti-proteinase-3, anti-MPO, anti-dsDNA and anti-GBM have an acceptable performance and are useful in the primary diagnostic work-up of patients suspected for secondary GN as the majority of such patients will be classified by these assays.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Antineutrophil Cytoplasmic
  • Antibodies, Antinuclear / blood
  • Autoantibodies / blood*
  • Basement Membrane / immunology
  • Fluorescent Antibody Technique
  • Glomerulonephritis / diagnosis
  • Glomerulonephritis / immunology*
  • Glomerulonephritis / pathology
  • Humans
  • Kidney / pathology
  • Kidney Glomerulus / immunology
  • Lupus Erythematosus, Systemic / immunology
  • Neutrophils / immunology
  • Vasculitis / immunology

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Antibodies, Antinuclear
  • Autoantibodies