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International consensus on antineutrophil cytoplasm antibodies testing in eosinophilic granulomatosis with polyangiitis

Moiseev, Sergey ; Bossuyt, Xavier ; Arimura, Yoshihiro ; Blockmans, Daniel ; Csernok, Elena ; Damoiseaux, Jan ; Emmi, Giacomo ; Flores-Suarez, Luis Felipe ; Hellmich, Bernhard and Jayne, David , et al. (2020) In American Journal of Respiratory and Critical Care Medicine 202(10). p.1360-1372
Abstract

An international consensus on antineutrophil cytoplasm antibodies (ANCA) testing in eosinophilic granulomatosiswith polyangiitis (EGPA) is presented.ANCA, specific formyeloperoxidase (MPO), can be detected in 30-35% of patients with EGPA. MPO-ANCA should be tested with antigen-specific immunoassays in any patient with eosinophilic asthma and clinical features suggesting EGPA, including constitutional symptoms; purpura; polyneuropathy; unexplained heart, gastrointestinal, or kidney disease; and/or pulmonary infiltrates or hemorrhage.Apositive MPO-ANCA result contributes to the diagnostic workup for EGPA. Patients with MPO-ANCA-associated EGPA have vasculitis features, such as glomerulonephritis, neuropathy, and skin manifestations, more... (More)

An international consensus on antineutrophil cytoplasm antibodies (ANCA) testing in eosinophilic granulomatosiswith polyangiitis (EGPA) is presented.ANCA, specific formyeloperoxidase (MPO), can be detected in 30-35% of patients with EGPA. MPO-ANCA should be tested with antigen-specific immunoassays in any patient with eosinophilic asthma and clinical features suggesting EGPA, including constitutional symptoms; purpura; polyneuropathy; unexplained heart, gastrointestinal, or kidney disease; and/or pulmonary infiltrates or hemorrhage.Apositive MPO-ANCA result contributes to the diagnostic workup for EGPA. Patients with MPO-ANCA-associated EGPA have vasculitis features, such as glomerulonephritis, neuropathy, and skin manifestations, more frequently than patients with ANCA-negative EGPA. However, the presence of MPO-ANCA is neither sensitive nor specific enough to identifywhether a patient should be subclassified as having "vasculitic"or "eosinophilic"EGPA. At present, ANCA status cannot guide treatment decisions, that is,whether cyclophosphamide, rituximab, ormepolizumab should be added to conventional glucocorticoid treatment. In EGPA, monitoring of ANCA is only useful when MPO-ANCA was tested positive at disease onset.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ANCA, Consensus, Eosinophilic granulomatosis with polyangiitis, Vasculitis
in
American Journal of Respiratory and Critical Care Medicine
volume
202
issue
10
pages
13 pages
publisher
American Thoracic Society
external identifiers
  • pmid:32584187
  • scopus:85096985242
ISSN
1073-449X
DOI
10.1164/rccm.202005-1628SO
language
English
LU publication?
yes
id
327239ce-1884-40f3-a1a9-20868bd17a92
date added to LUP
2020-12-11 10:52:39
date last changed
2024-06-13 01:57:22
@article{327239ce-1884-40f3-a1a9-20868bd17a92,
  abstract     = {{<p>An international consensus on antineutrophil cytoplasm antibodies (ANCA) testing in eosinophilic granulomatosiswith polyangiitis (EGPA) is presented.ANCA, specific formyeloperoxidase (MPO), can be detected in 30-35% of patients with EGPA. MPO-ANCA should be tested with antigen-specific immunoassays in any patient with eosinophilic asthma and clinical features suggesting EGPA, including constitutional symptoms; purpura; polyneuropathy; unexplained heart, gastrointestinal, or kidney disease; and/or pulmonary infiltrates or hemorrhage.Apositive MPO-ANCA result contributes to the diagnostic workup for EGPA. Patients with MPO-ANCA-associated EGPA have vasculitis features, such as glomerulonephritis, neuropathy, and skin manifestations, more frequently than patients with ANCA-negative EGPA. However, the presence of MPO-ANCA is neither sensitive nor specific enough to identifywhether a patient should be subclassified as having "vasculitic"or "eosinophilic"EGPA. At present, ANCA status cannot guide treatment decisions, that is,whether cyclophosphamide, rituximab, ormepolizumab should be added to conventional glucocorticoid treatment. In EGPA, monitoring of ANCA is only useful when MPO-ANCA was tested positive at disease onset. </p>}},
  author       = {{Moiseev, Sergey and Bossuyt, Xavier and Arimura, Yoshihiro and Blockmans, Daniel and Csernok, Elena and Damoiseaux, Jan and Emmi, Giacomo and Flores-Suarez, Luis Felipe and Hellmich, Bernhard and Jayne, David and Charles Jennette, J. and Little, Mark A. and Mohammad, Aladdin J. and Moosig, Frank and Novikov, Pavel and Pagnoux, Christian and Radice, Antonella and Sada, Ken Ei and Segelmark, Marten and Shoenfeld, Yehuda and Sinico, Renato A. and Specks, Ulrich and Terrier, Benjamin and Tzioufas, Athanasios G. and Vaglio, Augusto and Zhao, Ming Hui and Tervaert, Jan Willem Cohen}},
  issn         = {{1073-449X}},
  keywords     = {{ANCA; Consensus; Eosinophilic granulomatosis with polyangiitis; Vasculitis}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1360--1372}},
  publisher    = {{American Thoracic Society}},
  series       = {{American Journal of Respiratory and Critical Care Medicine}},
  title        = {{International consensus on antineutrophil cytoplasm antibodies testing in eosinophilic granulomatosis with polyangiitis}},
  url          = {{http://dx.doi.org/10.1164/rccm.202005-1628SO}},
  doi          = {{10.1164/rccm.202005-1628SO}},
  volume       = {{202}},
  year         = {{2020}},
}