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Nat. Rev. Rheumatol. doi:10.1038/nrrheum.2017.140 Figure 3 Visual representation of the 1999 recommendations and revised 2017 recommendations Figure 3 | Visual representation of the 1999 recommendations and revised 2017 recommendations. a| In the 1999 consensus document, the recommended approach for anti-neutrophil cytoplasmic antibody (ANCA) detection was to screen for ANCA by indirect immunofluorescence (IIF) and to test for proteinase 3 (PR3)-ANCAs and myeloperoxidase (MPO)-ANCAs in IIF-positive samples; the ideal approach was to perform IIF and immunoassay on all samples. b| In the 2017 consensus, the use of high-quality immunoassays is recommended as the preferred first screening method for ANCA detection in patients suspected of having the ANCA-associated vaculitides granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). ANCA detection for non-ANCA-associated vasculitis conditions is not included in this consensus. *A second PR3-MPO-ANCA or IIF can be considered for negative results in patients with a high clinical suspicion (to increase sensitivity) or in case of low antibody levels (to increase specificity). Take antibody level into account. Bossuyt, X. et al. (2017) Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis Nat. Rev. Rheumatol. doi:10.1038/nrrheum.2017.140