Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter October 16, 2020

Harmonization of antineutrophil cytoplasmic antibodies (ANCA) testing by reporting test result-specific likelihood ratios: position paper

Xavier Bossuyt, Jan Damoiseaux, Niels Rasmussen, Pieter van Paassen, Bernard Hellmich, Bo Baslund, Daniel Blockmans, Pieter Vermeersch, Marcos Lopez-Hoyos, Martine Vercammen, Elisa Barret, Friederike Hammar, Ulrich Leinfelder, Michael Mahler, Nina Olschowka, Dirk Roggenbuck ORCID logo, Wolfgang Schlumberger, Roger Walker, Johan Rönnelid, Jan-Willem Cohen Tervaert, Elena Csernok, Walter Fierz and for (i) the European Federation of Laboratory Medicine (EFLM) Task and Finish Group “Autoimmunity Testing,” (ii) the European Autoimmune Standardization Initiative (EASI) and the (iii) European Consensus Finding Study Group on autoantibodies (ECFSG)

Corresponding author: Xavier Bossuyt, Laboratory Medicine, University Hospitals Gasthuisberg, Herestraat 49, 3000Leuven, Belgium; and Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium, Phone: +32 16 347009, Fax: +32 16 347931, E-mail:


We thank Ingrid Zegers and Evanthia Monogioudi (European Commission, Joint Research Centre, Geel, Belgium) for providing the reference materials and for helpful discussions.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: XB has received speaker fees from Thermo Fisher Scientific and Inova, has been a consultant for Thermo Fisher Scientific and Inova and has received research support from Thermo Fisher Scientific. JD has received speaker fees from Thermo Fisher Scientific, Euroimmun, and Inova. BH has received a speaker fee from Orgentec, EC has received lecture fees from Bio-Rad Lab, Medipan/Generic Assays, Inova Diagnostics, Orgentec and Thermo Fisher. JR has been a consultant for Thermo Fisher Scientific. WF has received speaker fees from Thermo Fisher Scientific. MLH has received speaker fees from Thermo Fisher Scientific and Inova, has been a consultant for Thermo Fisher Scientific and Inova. MM is employed by Inova Diagnostics, WS received personal fees from Euroimmun, NO received personal fees from Thermo Fisher Scientific, FH and UL are employed by Orgentec, DR received personal fees from Medipan and Generic Assays, EB and RW are employed by BioRad. PV is a senior clinical investigator of the Fund for Scientific Research – Flanders. WF has received speaker fees from Thermo Fisher and is president of the Schweizerischer Verband der Diagnostikindustrie (SVDI).

  4. Ethical approval: Research involving human subjects complied with the World Medical Association Declaration of Helsinki (as revised in 2013).

  5. Data availability: Data are available upon request to the corresponding author.


1. Bossuyt, X, Cohen Tervaert, JW, Arimura, Y, Blockmans, D, Flores-Suárez, LF, Guillevin, L, et al. Position paper: revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis. Nat Rev Rheumatol 2017;13:683–92. in Google Scholar

2. Bossuyt, X, Dillaerts, D, Mahler, M, Roggenbuck, D, Leinfelder, U, Hammar, F, et al. Standardization of PR3-ANCA and MPO-ANCA: evaluation of certified reference materials. Ann Rheum Dis 2020 Jun 16:annrheumdis-2020-217416. [Epub ahead of print].Search in Google Scholar

3. Bossuyt, X, Rasmussen, N, van Paassen, P, Hellmich, B, Baslund, B, Vermeersch, P, et al. A multicentre study to improve clinical interpretation of proteinase-3 and myeloperoxidase anti-neutrophil cytoplasmic antibodies. Rheumatology 2017;56:1533–41. in Google Scholar

4. Damoiseaux, J, Csernok, E, Rasmussen, N, Moosig, F, van Paassen, P, Baslund, B, et al. Detection of antineutrophil cytoplasmic antibodies (ANCAs): a multicentre European Vasculitis Study Group (EUVAS) evaluation of the value of indirect immunofluorescence (IIF) versus antigen-specific immunoassays. Ann Rheum Dis 2017;76:647–53. in Google Scholar

5. Fierz, W. Likelihood ratios of quantitative laboratory results in medical diagnosis: the application of Bézier curves in ROC analysis. PLoS One 2018;13:e0192420. in Google Scholar

6. Bossuyt, X, Claessens, J, Belmondo, T, De Langhe, E, Westhovens, R, Poesen, K, et al. Harmonization of clinical interpretation of antinuclear antibody test results by solid phase assay and by indirect immunofluorescence through likelihood ratios. Autoimmun Rev 2019;18:102386. in Google Scholar

Supplementary Material

The online version of this article offers supplementary material (

Received: 2020-08-01
Accepted: 2020-08-27
Published Online: 2020-10-16
Published in Print: 2021-02-23

© 2020 Walter de Gruyter GmbH, Berlin/Boston