Rao JK, Weinberger M, Oddone EZ, Allen NB, Landsman P, Feussnr JR
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- stage 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. (Leehey)

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Proteinuria/Hematuria : Vasculitis (Wegener's PAN, etc.)