What are ANCAs

What are ANCAs?

ANCAs are antibodies directed against specific antigens present in the cytoplasm of neutrophils. There are three different types of IIF staining patterns for ANCAs using ethanol-fixed neutrophils as substrate:

• C-ANCA pattern: diffuse cytoplasmic staining on immunofluorescence. The most common antibodies causing this pattern are directed against serine PR3. Less commonly, the target antigen is bactericidal/permeability-increasing protein or others.

• P-ANCA pattern: perinuclear staining pattern around the nucleus. The most important antibody causing this pattern is directed against MPO. Other antigen targets include elastase, cathepsin G, lactoferrin, lysozyme, and azurocidin.

• Atypical ANCA pattern: snow-drift staining pattern around nucleus often confused with the P-ANCA pattern. Usually seen in patients with inflammatory bowel disease, connective tissue diseases, or autoimmune hepatitis.

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