Rao JK, Weinberger M, Oddone EZ, Allen NB, Landsman P,
The role of antineutrophilic cytoplasmic antibody (c-ANCA)
testing in the diagnosis of Wegener's granulomatosis
Ann Intern Med
(Dec) 123:925-932 1995
A metaanalysis using a structured literature search (MEDLINE) yielded 747
articles for potential inclusion. These articles then went through a 4-
review, resulting in 15 articles in which a systematic method of patient
selection was used and a 2x2 contigency table of the results could be
constructed. All studies measured cANCA by indirect immunofluorescence.
Sensitivity and specificity of cANCA testing ranged from 34 to 92% and 88 to
100%, respectively. For active disease, sensitivity was 91% and specificity
99%. The cANCA test is probably most valuable when the prevalence of the
disease is about 5-10%. Although the test is highly specific for active
disease, false positive results can still occur in low prevalence
populations. The authors therefore recommend judicious testing and cautious
interpretation of test results. Biopsy is still necessary in doubtful cases.
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Vasculitis (Wegener's PAN, etc.)