{
  "abstract": "Objectives: In 2017 a new consensus for antineutrophil cytoplasmic antibody (ANCA) testing was published, based on data from tertiary referral centres for ANCA-associated vasculitis (AAV). AAV-prevalence in their tested population was relatively high. We analysed how the consensus approach performs in a large teaching hospital and tailored it to secondary care settings with lower patient prevalences in their population. Methods: Patients screened for ANCA between 2012–2023 were included; clinical data were retrospectively collected. Indirect immunofluorescence (IIF) was performed using EUROPLUSTM Granulocyte Mosaic 25 IIF. MPO/PR3 was detected by ImmunoCAP®250. Statistical analyses were performed in R. Results: 286/5518 (5.2%) patients tested for ANCA were positive: 63% had no AAV. Non-AAV patients often had other autoimmune diseases, malignancies, infections or used specific drugs. IIF and ELISA as first test showed good negative predictive values. ELISA as first test showed higher positive predictive value and specificity; performing a second test increased specificity. ANCA concentrations were higher in AAV than non-AAV, but ranges were wide. Conclusion: The majority of ANCA-positive patients did not have AAV. In our secondary care setting, ELISA performs best as first test to rule out and to rule in AAV. A second test should be considered with high clinical suspicion and a negative first test, or with low antibody concentrations, following the consensus. Additionally, we propose a second test when there is clinical doubt and a positive first test. This increases specificity and PPV, reducing false positives, which is especially relevant in secondary care settings.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands",
    "Pathology Laboratory, Pathan B.V., Rotterdam, The Netherlands",
    "Department of Rheumatology and Clinical Immunology, Maasstad Hospital, Rotterdam, The Netherlands",
    "Business Intelligence, Maasstad Hospital, Rotterdam, The Netherlands",
    "Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands",
    "Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands",
    "Laboratory of Clinical Chemistry, MaasstadLab, Maasstad Hospital, Rotterdam, The Netherlands",
    "Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Maria A. C. Wester Trejo"
    },
    {
      "affs": [
        1
      ],
      "name": "Tjallingius Martijn Kuijper"
    },
    {
      "affs": [
        2
      ],
      "name": "Geeke J. Waverijn"
    },
    {
      "affs": [
        3
      ],
      "name": "Ingeborg M. Bajema"
    },
    {
      "affs": [
        4
      ],
      "name": "René M. A. van den Dorpel"
    },
    {
      "affs": [
        5
      ],
      "name": "Marc R. Kok"
    },
    {
      "affs": [
        6
      ],
      "name": "Iris J. A. M. Verberk-Jonkers"
    },
    {
      "affs": [
        7
      ],
      "name": "Els J. M. Zirkzee"
    },
    {
      "name": "Snjezana Kos"
    },
    {
      "name": "Annelies E. Berden"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0r5gewrmfatrv.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0357495",
  "fulltext_url": null,
  "id": "0r5gewrmfatrv",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0357495",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Vasculitis and related conditions"
    ],
    [
      "plos",
      "/Biology and life sciences/Immunology/Clinical immunology/Autoimmune diseases"
    ],
    [
      "plos",
      "/Biology and life sciences/Immunology/Clinical immunology/Autoimmune diseases/Vasculitis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Clinical immunology/Autoimmune diseases"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Clinical immunology/Autoimmune diseases/Vasculitis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Hematology/Hematologic cancers and related disorders"
    ],
    [
      "plos",
      "/Medicine and health sciences/Immunology/Clinical immunology/Autoimmune diseases"
    ],
    [
      "plos",
      "/Medicine and health sciences/Immunology/Clinical immunology/Autoimmune diseases/Vasculitis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Inflammatory diseases/Vasculitis"
    ],
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      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Hematologic cancers and related disorders"
    ],
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      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Melanoma"
    ],
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      "plos",
      "/Medicine and health sciences/Rheumatology/Vasculitis"
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      "/Research and analysis methods/Bioassays and physiological analysis/Biochemical analysis/Enzyme assays"
    ],
    [
      "plos",
      "/Research and analysis methods/Immunologic techniques/Immunoassays"
    ],
    [
      "plos",
      "/Research and analysis methods/Immunologic techniques/Immunoassays/Enzyme-linked immunoassays"
    ],
    [
      "plos",
      "/Research and analysis methods/Immunologic techniques/Immunoassays/Immunofluorescence"
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  "openalex": "W7212075083",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0357495&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-09",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/0r5gewrmfatrv.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:56Z",
      "native_id": "10.1371/journal.pone.0357495",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0357495"
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  "subjects": [
    {
      "field": "biology",
      "origin": "plos:immunology",
      "subfield": "immunology"
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    {
      "field": "medicine",
      "origin": "plos:cancers and neoplasms",
      "subfield": "oncology"
    }
  ],
  "title": "ANCA testing strategies: A single centre experience over the past decade in a large teaching hospital in the Netherlands",
  "title_text": "ANCA testing strategies: A single centre experience over the past decade in a large teaching hospital in the Netherlands",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:56Z",
  "url": "https://research.draconitic.com/paper/0r5gewrmfatrv",
  "venue": "PLOS One",
  "versions": []
}