ANCA serology in the diagnosis and management of ANCA-associated renal vasculitis

GUIDELINES a. Serum anti-neutrophil cytoplasmic antibody (ANCA) measurement should not be used alone in the initial diagnosis of ANCA-associated vasculitis (AAV) but should be used in combination with the gold standard of tissue diagnosis. (Level 1 evidence) b. Measurement of ANCA by both ELISA and indirect immunofluorescence (IIF) in combination ensures optimal test sensitivity and specificity. (Level I evidence) c. The use of serial ANCA monitoring alone is insufficient to predict relapse or monitor disease activity. (Level I evidence)