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Clinical and Developmental Immunology
Volume 2012 (2012), Article ID 762874, 7 pages
http://dx.doi.org/10.1155/2012/762874
Research Article

Automatic Reading of ANCA-Slides: Evaluation of the AKLIDES System

Laboratory of Clinical Immunology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands

Received 2 October 2012; Accepted 10 October 2012

Academic Editor: Dimitrios P. Bogdanos

Copyright © 2012 Jan Damoiseaux et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The ANCA consensus prescribes screening by indirect immunofluorescence on neutrophils. We evaluated the first automated ANCA-pattern recognition system. C-ANCA and P-ANCA samples were selected from patients with ANCA-associated vasculitis (AAV). Non-AAV controls included sera from healthy controls , sera with possible interfering antibodies , or miscellaneous ANCA reactivity . ANCA slides were analysed by AKLIDES and routine fluorescence microscopy. The C-ANCA pattern was recognized by routine microscopy in 92% and 97% on ethanol- and formalin-fixed slides, respectively. AKLIDES reported C-ANCA in 74% and 95%, respectively. P-ANCA was recognized by routine microscopy on ethanol-fixed neutrophils in 90%, while AKLIDES reported P-ANCA in 80%. Typically, only 65% and 33% of these samples showed the expected C-ANCA on formalin-fixed neutrophils by routine microscopy and AKLIDES, respectively. A C- or P-ANCA pattern was observed on ethanol-fixed neutrophils in 28% and 23% of the controls by routine microscopy and AKLIDES, respectively. Only 5% of the controls revealed C-ANCA on formalin-fixed neutrophils by routine microscopy and AKLIDES. Altogether, automated ANCA-pattern recognition by AKLIDES is promising. Distinction of C- and P-ANCA is good, but sensitivity on ethanol-fixed neutrophils needs improvement. When optimized, pattern recognition software may play an important role in AAV diagnostics.