Original Article
Antineutrophil Cytoplasm Antibody: Positivity and Clinical Correlation
Anticuerpos contra el citoplasma del neutrófilo: positividad y correlación clínica
Read
13042
Timeswas read the article
2485
Total PDF
10557
Total HTML
Share statistics
array:23 [ "pii" => "S2173574314001166" "issn" => "21735743" "doi" => "10.1016/j.reumae.2014.02.010" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "665" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2013" "documento" => "article" "subdocumento" => "fla" "cita" => "Reumatol Clin. 2015;11:17-21" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2693 "formatos" => array:3 [ "EPUB" => 65 "HTML" => 2222 "PDF" => 406 ] ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S1699258X14000576" "issn" => "1699258X" "doi" => "10.1016/j.reuma.2014.02.010" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "665" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "subdocumento" => "fla" "cita" => "Reumatol Clin. 2015;11:17-21" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 42518 "formatos" => array:3 [ "EPUB" => 210 "HTML" => 33674 "PDF" => 8634 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Anticuerpos contra el citoplasma del neutrófilo: positividad y correlación clínica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "17" "paginaFinal" => "21" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Antineutrophil cytoplasm antibody: Positivity and clinical correlation" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1107 "Ancho" => 1667 "Tamanyo" => 137769 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Curva ROC obtenida con la determinación de anticuerpos contra el citoplasma del neutrófilo mediante IFI a diferentes puntos de corte y con la confirmación de especificidades antigénicas mediante ELISA en los pacientes negativos de anticuerpos antinucleares.</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">ELISA: ensayo de inmunoabsorción ligado a enzima; IFI: inmunofluorescencia indirecta.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Goitybell Martínez Téllez, Bárbara Torres Rives, Suchiquil Rangel Velázquez, Vicky Sánchez Rodríguez, María Antonia Ramos Ríos, Lisset Evelyn Fuentes Smith" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Goitybell" "apellidos" => "Martínez Téllez" ] 1 => array:2 [ "nombre" => "Bárbara" "apellidos" => "Torres Rives" ] 2 => array:2 [ "nombre" => "Suchiquil" "apellidos" => "Rangel Velázquez" ] 3 => array:2 [ "nombre" => "Vicky" "apellidos" => "Sánchez Rodríguez" ] 4 => array:2 [ "nombre" => "María Antonia" "apellidos" => "Ramos Ríos" ] 5 => array:2 [ "nombre" => "Lisset Evelyn" "apellidos" => "Fuentes Smith" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574314001166" "doi" => "10.1016/j.reumae.2014.02.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001166?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14000576?idApp=UINPBA00004M" "url" => "/1699258X/0000001100000001/v2_201706020231/S1699258X14000576/v2_201706020231/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2173574314001026" "issn" => "21735743" "doi" => "10.1016/j.reumae.2014.03.019" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "673" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "subdocumento" => "fla" "cita" => "Reumatol Clin. 2015;11:22-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2673 "formatos" => array:3 [ "EPUB" => 62 "HTML" => 2175 "PDF" => 436 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Symptomatic Pain and Fibromyalgia Treatment Through Multidisciplinary Approach for Primary Care" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "22" "paginaFinal" => "26" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento sintomático y del dolor en fibromialgia mediante abordaje multidisciplinar desde Atención Primaria" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jaime Gonzalez Gonzalez, Maria del Mar del Teso Rubio, Carmen Nelida Waliño Paniagua, Juan Jose Criado-Alvarez, Javier Sanchez Holgado" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Jaime" "apellidos" => "Gonzalez Gonzalez" ] 1 => array:2 [ "nombre" => "Maria del Mar" "apellidos" => "del Teso Rubio" ] 2 => array:2 [ "nombre" => "Carmen Nelida" "apellidos" => "Waliño Paniagua" ] 3 => array:2 [ "nombre" => "Juan Jose" "apellidos" => "Criado-Alvarez" ] 4 => array:2 [ "nombre" => "Javier" "apellidos" => "Sanchez Holgado" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X14000813" "doi" => "10.1016/j.reuma.2014.03.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14000813?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001026?idApp=UINPBA00004M" "url" => "/21735743/0000001100000001/v1_201501160858/S2173574314001026/v1_201501160858/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2173574315000039" "issn" => "21735743" "doi" => "10.1016/j.reumae.2014.02.015" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "662" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "subdocumento" => "fla" "cita" => "Reumatol Clin. 2015;11:12-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1953 "formatos" => array:3 [ "EPUB" => 61 "HTML" => 1458 "PDF" => 434 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Rheumatoid arthritis-associated interstitial lung disease: Lung inflammation evaluated with high resolution computed tomography scan is correlated to rheumatoid arthritis disease activity" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "12" "paginaFinal" => "16" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad intersticial pulmonar asociada a Artritis Reumatoide: La inflamación pulmonar evaluada mediante tomografía computarizada de alta resolución correlaciona con la actividad de la enfermedad de Artritis Reumatoide" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1206 "Ancho" => 1633 "Tamanyo" => 82885 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Spearman's rank correlation coefficient for ground-glass and CDAI scores (<span class="elsevierStyleItalic">r<span class="elsevierStyleInf">s</span></span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.3767) (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.0281).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Renzo Pérez-Dórame, Mayra Mejía, Heidegger Mateos-Toledo, Jorge Rojas-Serrano" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Renzo" "apellidos" => "Pérez-Dórame" ] 1 => array:2 [ "nombre" => "Mayra" "apellidos" => "Mejía" ] 2 => array:2 [ "nombre" => "Heidegger" "apellidos" => "Mateos-Toledo" ] 3 => array:2 [ "nombre" => "Jorge" "apellidos" => "Rojas-Serrano" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1699258X14000540" "doi" => "10.1016/j.reuma.2014.02.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14000540?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574315000039?idApp=UINPBA00004M" "url" => "/21735743/0000001100000001/v1_201501160858/S2173574315000039/v1_201501160858/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Antineutrophil Cytoplasm Antibody: Positivity and Clinical Correlation" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "17" "paginaFinal" => "21" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Goitybell Martínez Téllez, Bárbara Torres Rives, Suchiquil Rangel Velázquez, Vicky Sánchez Rodríguez, María Antonia Ramos Ríos, Lisset Evelyn Fuentes Smith" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Goitybell" "apellidos" => "Martínez Téllez" "email" => array:1 [ 0 => "goity@infomed.sld.cu" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Bárbara" "apellidos" => "Torres Rives" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Suchiquil" "apellidos" => "Rangel Velázquez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Vicky" "apellidos" => "Sánchez Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "María Antonia" "apellidos" => "Ramos Ríos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Lisset Evelyn" "apellidos" => "Fuentes Smith" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Laboratorio de Inmunología, Centro Nacional de Genética Médica, La Habana, Cuba" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro Nacional de Genética Médica, La Habana, Cuba" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Anticuerpos contra el citoplasma del neutrófilo: positividad y correlación clínica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1094 "Ancho" => 1597 "Tamanyo" => 151376 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">ROC obtained with the determination of antibodies against neutrophil cytoplasm by IIF at different cutoff points and confirmation of antigenic specificities by ELISA in patients negative for antinuclear antibodies. ELISA: enzyme-linked immunosorbent assay; IIF: indirect immunofluorescence.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Anti-neutrophil cytoplasm antibodies (ANCA) are a group of autoantibodies directed against the cytoplasmic constituents of neutrophils and monocytes. Their determination constitutes a diagnostic test for small-vessel vasculitis associated with ANCA (AAV) including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA) and vasculitis limited to the kidney.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The presence of ANCA is determined by indirect immunofluorescence (IIF) from fixed neutrophils on glass slides and fluorescence positivity must be confirmed by the enzyme-linked immunosorbent assay enzyme (ELISA) to determine the antigenic specificity, although some authors suggest that the simultaneous use of both methods has shown greater diagnostic value.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">There are two main patterns of fluorescence depending on the purpose of the ANCA. The cytoplasmic pattern (cANCA) refers to the pattern with which the cytoplasm stains under immunofluorescent microscope when neutrophils are fixed with ethanol or acetone. The main cANCA antigen is proteinase 3 (PR3). The perinuclear pattern (pANCA) refers to the staining pattern of neutrophils, which occurs only when they are fixed in ethanol or acetone, to permeabilize the membrane of the cytoplasmic granules, and allows highly cationic proteins, such as myeloperoxidase (MPO), to exit and bind to the negatively charged nuclear membrane. When neutrophils are fixed in formalin, this pANCA pattern is observed as cANCA because the attraction effect of cationic proteins to the nucleus<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> is reduced.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Over 90% of patients with active typical GPA have identifiable antibodies against PR3, with a sensitivity of 28%–92%, depending on the expression of the disease, and a specificity of 80%–100%; while between 80% and 70% of patients with PAM and between 70% and 85% of EGPA patients have identifiable MPO antibodies.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">It has been confirmed that the pANCA pattern can be observed when the antibodies react with antigens other than MPO, something called an atypical pANCA pattern. Perinuclear fluorescence without nuclear extension is also known as atypical pANCA.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Some authors have also suggested that there is a cANCA atypical pattern combining perinuclear fluorescence with nuclear extension and cytoplasmic fluorescence. This pattern can be produced by the interference of antinuclear antibodies (ANA).<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Hence the importance of the simultaneous determination of ANA and ANCA determination, although there are few studies on the prevalence of ANCA patterns by IIF in different diseases, differentiating the presence or absence of ANA.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Atypical patterns may have antigenic specificities against nuclear, cytosolic or granular components and they include elastase, cathepsin G, bactericidal permeability enhancer (BPE), betaglucoronidase, lysozyme, lactoferrin, catalase, alpha enolase, actin, histone, among others.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Some authors suggest the usefulness of ANCA is not only to diagnose AAV, but also to diagnose and assess the prognosis of other inflammatory or autoimmune disorders, where the pattern of associated IIF is usually described as pANCA, although there have been cANCA or atypical patterns.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,7,9,10</span></a> ANCA positivity has also been described in infectious and malignant hematological diseases.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,11,12</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The objective of this study was to determine the positivity and clinical correlation of ANCA, taking into account the interference of ANA in patients treated at the Laboratory of Immunology at the National Centre for Medical Genetics (NCMG) of Cuba in 2012.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and Methods</span><p id="par0055" class="elsevierStylePara elsevierViewall">A prospective study was performed with patients referred to the Laboratory of Immunology of the NCMG of Cuba in 2012.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075"><span class="elsevierStyleItalic">Patients</span></span><p id="par0060" class="elsevierStylePara elsevierViewall">The sample consisted of 267 patients with indications for ANCA determination: 35 with suspected systemic lupus erythematosus (SLE), 60 with confirmed SLE, 17 with suspected AAV,13 with AAV, 91 with rheumatoid arthritis (RA), 10 with viral hepatitis, 14 with scleroderma, 8 with mixed connective tissue disease, 4 with Sjögren's syndrome, five with autoimmune hepatitis (AIH) type <span class="elsevierStyleSmallCaps">i,</span> 3 with ulcerative colitis (UC), 3 with Raynaud's phenomenon, 2 with dermatomyositis, one with primary biliary cirrhosis and one with spondyloarthropathy. The diagnosis of AAV was performed according to the criteria established by the Conference of Chapell Hill.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13–15</span></a> The diagnosis of other patients was performed by clinicians and immunologists with criteria for each disease.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">Methods</span></span></span><p id="par0065" class="elsevierStylePara elsevierViewall">ANA determination was performed by IIF, considering as positivity titers starting at 1/80 and using a commercial assay (ORGENTEC, Germany). The determination of ANCA was performed by IIF on ethanol-fixed and formalin human neutrophils, considering positivity from 1/20<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>; determinations of anti-PR3 and anti-MPO were performed by ELISA (ORGENTEC, Germany) to patients who were positive for ANCA by IIF, using as cutoff 5<span class="elsevierStyleHsp" style=""></span>IU / mL. 2 IIF patterns were identified: cANCA (cytoplasmic fluorescence), pANCA (perinuclear fluorescence without nuclear extension).ANCA positive samples were titrated by IIF. The titer was considered as the highest dilution at which the ANCA pattern was clearly observed. Sensitivity and specificity of ANCA determination by IIF was determined using different cutoffs and confirming the antigenic specificities by ELISA.</p><p id="par0070" class="elsevierStylePara elsevierViewall">For statistical analysis we used the Statistica 7.0 and 3.1 EPIDAT programs. To analyze the influence of ANA positivity in determining ANCA, the ¿<span class="elsevierStyleSup">2</span> statistic was calculated as well as odds ratios (OR) and the magnitude of association with their respective confidence interval of 95%. Different cutoffs were compared in terms of their discrimination capability, using the area under the curve (AUC) of the receiver operating curve characteristics (ROC curves).</p><p id="par0075" class="elsevierStylePara elsevierViewall">Research fulfilled the Declaration of Helsinki of the World Medical Association criteria, which establishes the ethical principles for medical research involving human subjects.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> The study was approved by the Ethics Committee of the NCMG.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Informed consent for participation was obtained from patients in the office, with sufficient time to decide whether to participate and before blood was drawn.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085"><span class="elsevierStyleBold">Results</span></span><p id="par0085" class="elsevierStylePara elsevierViewall">The mean age of the patients included in the study was 40 years, ranging from 1 to 75 years. Only 17% of patients had an age greater than or equal to 60 years. 73% of patients (195) were females and of the total group of patients, 56% (150) were negative for ANA (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Of the 150 ANA negative patients, 40 (27%) had ANCA by IIF and of these 10 patients (25%) had anti-PR3 and anti-MPO (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) antibodies. In this group of patients, the anti-PR3 antibodies corresponded to a cANCA pattern and all anti-MPO antibodies corresponded to a positive pANCA in formalin.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Of the 117 ANA positive patients, 57 (49%) had ANCA by IIF. All these positive ANCA patients by IIF were negative for anti-PR3 and anti-MPO antibodies. 51 pANCA patterns obtained, 6 were positive in formalin and were not associated with anti-MPO (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>) antibodies.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">This study found that the the probability of finding ANCA as determined by IIF assay without antigenic specificity to MPO or PR3 is greater when ANA are positive (OR=3.8, 95% CI [2.15–6.71]).</p><p id="par0105" class="elsevierStylePara elsevierViewall">As shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>, the highest positivity for ANCA with respect to all negative ANA patients studied in each disease corresponded to patients with: UC, AAV, Sjögren's syndrome, AIH type <span class="elsevierStyleSmallCaps">I,</span> RA, hepatitis, SLE and infectious disease. The presence of pANCA pattern was greater than the cANCA pattern and was observed in all diseases where these antibodies were detected except the GPA. The cANCA pattern was present in SLE, AAV, AR, infectious hepatitis, Sjögren's syndrome and UC.</p><p id="par0110" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> we can see the results of sensitivity and specificity at different cutoff values obtained with ANCA determination by IIF in the group of patients with negative ANA. The AUC of the ROC curves for the determination of ANCA in the diagnosis of AAV was 0.7016 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The best balance of sensitivity and specificity was obtained for patients diagnosed with AAV using the 1/80 cutoff. ANCA was determined by IIF and confirmation of anti-PR3 or anti-MPO specificity was done using ELISA according to the pattern of immunofluorescence, only showing diagnostic value for this group of diseases.</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The values of anti-PR3 and anti-MPO antibodies were not greater than 10<span class="elsevierStyleHsp" style=""></span>IU/mL in all positive cases, making them unable to compare at different cutoffs.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0120" class="elsevierStylePara elsevierViewall">Most patients included in the study, ANA negative and ANCA positive, were female. This is consistent with the increased incidence of autoimmune diseases in this gender.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">The presence of ANA was observed in a large number of patients included in the study, which coincides with the statements in the literature for this type of disease (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> It is well known that these antibodies are present in more than 95% of patients with SLE.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Importantly, most patients with SLE and ANCA indication were negative for ANA at a titer of 1/80, although not all patients had SLE, since a large group of patients with this diagnosis seen in this institution were not included in the study because they have no indication of ANCA. All these SLE patients considered negative for ANA presented titers below 1/80. We believe that future studies should examine the cutoff value for determination of ANA in these patients and the effective use of the diagnostic criteria for referral to an immunology laboratory.</p><p id="par0135" class="elsevierStylePara elsevierViewall">The results obtained in patients with ANA show that the presence of ANCA can be due to the presence of antibodies against antigens different from PR3 and MPO, or interference in the ANA IIF technique. It would have been very useful in these patients to determine the presence of ANCA by ELISA against other antigens besides PR3 and MPO.</p><p id="par0140" class="elsevierStylePara elsevierViewall">Some authors combined the IIF technique with ethanol-fixed neutrophils followed by formalin-fixed neutrophils, because the latter tends to fade when there is fluorescence positivity in ethanol produced by interference of ANA or when there are antigens different to<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,6,7</span></a> MPO.</p><p id="par0145" class="elsevierStylePara elsevierViewall">The concordance of the formalin test confirmation with respect to ELISA in the determination of anti-MPO antibodies was lower in patients with the presence of ANA. A group of these pANCA pattern patients were negative for anti-MPO antibodies and, when confirming these patterns in formalin, a cANCA pattern was obtained. This shows that the formalin test plates not always identify whether ANCA positivity in ethanol is due to the presence of antibodies against MPO.</p><p id="par0150" class="elsevierStylePara elsevierViewall">Moreover, in a study by Pollock et al. that evaluated the use of formalin test plates to confirm the pANCA pattern in ethanol, the limitation of this technique was demonstrated in comparison with most of the MPO ELISA.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">In our opinion, faced with the presence of ANA, ANCA determination by IIF formalin plates does not provide much information.</p><p id="par0160" class="elsevierStylePara elsevierViewall">Some authors only define the pANCA pattern on ethanol that disappears in formalin as positive for ANCA for antigens different to MPO, if the determination of ANA is negative.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">The results obtained in the Laboratory of Immunology of the NCMG show the large number of clinicopathological entities with presence of ANCA (<a class="elsevierStyleCrossRefs" href="#tbl0010">Tables 2 and 3</a>). The diseases that showed most ANCA positivity found in this study are largely consistent with those reported in the literature: UC (60%–80%), AIH type <span class="elsevierStyleSmallCaps">I</span> (85%–95%), SLE (70%), RA without ANA (20%–30%), scleroderma, Sjögren's syndrome, polymyositis/dermatomyositis, juvenile chronic arthritis, reactive arthritis, primary sclerosing cholangitis and rapidly progressive pauci-immune glomerulonephritis (RPGN).<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,9,20,21</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">In patients with SLE and RA, the positivity of the atypical pattern without MPO antibody specificity observed in our study is consistent with other studies where patterns are associated with atypical pANCA with antigenic specificities against lactoferrin.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,10,22</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">In our study a group of patients with SLE had a cANCA pattern although mostly without anti-PR3 (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) antibodies. In the literature, this disease is commonly associated with cANCA. For future studies the determination of different antigenic specificities by ELISA would be very useful in these cases.</p><p id="par0180" class="elsevierStylePara elsevierViewall">In patients with RA negative for ANA, most of the patterns obtained by IIF were pANCA without anti-MPO (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) antibodies. The literature points to the presence of ANCA in RA, generally atypical pANCA, associated to antilactoferrin antibodies, although antibodies against BPE that a is associated to cANCA<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,10,22</span></a> may also occur.</p><p id="par0185" class="elsevierStylePara elsevierViewall">In patients with AIH type <span class="elsevierStyleSmallCaps">I</span> negative ANA, a (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) pANCA pattern was obtained. In the literature, the presence of ANCA is reported in these patients.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">In patients with CU, positivity for anti-PR3 and anti-MPO (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) antibody was observed. Although studies were not found in the related literature, some authors suggest the presence of ANCA faced with PR3 due to polyclonal B cell responses during systemic inflammation associated with autoimmunity, malignancy and, in particular infections.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a></p><p id="par0195" class="elsevierStylePara elsevierViewall">In patients with Sjögren's syndrome we observed cANCA and pANCA (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) patterns. The presence of ANCA has been described in these patients associated with pANCA or atypical patterns, usually with no reactivity to PR3 or against MPO. It has also been reported that antibodies can appear against cathepsin G associated to a pANCA pattern.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">The analysis of sensitivity and specificity obtained for the determination of ANCA by IIF, when a cutoff greater than 1/80 is used, is similar to that obtained in other studies in patients with AAV. The result obtained in the determination by IIF followed by confirmation by ELISA also coincides with what has been proposed in the literature (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>, <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">The fact that these antibodies are present in high titers in patients without AAV, when determined by IIF, but are not reactive to PR3 and MPO, confirms ELISA use in conjunction with IIF technique to establish a better diagnosis.</p><p id="par0210" class="elsevierStylePara elsevierViewall">ANCA was shown to be present on a wide number of inflammatory and autoimmune associated states besides AAV, usually with no reactivity to PR3 and MPO. Although a pANCA pattern was observed in most patients without AAV, it is important to note the presence of a cANCA pattern, especially in patients with SLE in the population studied.</p><p id="par0215" class="elsevierStylePara elsevierViewall">Determination of ANCA by IIF maintains its usefulness in ANA-negative patients, especially when titers at or above 1/80 are obtained, followed by determination of anti-PR3 and anti-MPO antibody by ELISA. The utility of the assay of IIF on formalin plates is less than the determination of anti-MPO antibody by ELISA when ANA are present.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Ethical disclosures</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Protection of human and animal subjects</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association (Declaration of Helsinki).</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Confidentiality of data</span><p id="par0230" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Right to privacy and informed consent</span><p id="par0235" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflict of Interest</span><p id="par0220" class="elsevierStylePara elsevierViewall">The authors have no disclosures to make.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:2 [ "identificador" => "xres411380" "titulo" => array:5 [ 0 => "Abstract" 1 => "Objective" 2 => "Material and methods" 3 => "Results" 4 => "Conclusion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec387017" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres411379" "titulo" => array:5 [ 0 => "Resumen" 1 => "Objetivo" 2 => "Material y método" 3 => "Resultados" 4 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec387018" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Methods" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Results" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 10 => array:3 [ "identificador" => "sec0040" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0055" "titulo" => "Right to privacy and informed consent" ] ] ] 11 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of Interest" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-04-16" "fechaAceptado" => "2014-02-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec387017" "palabras" => array:6 [ 0 => "Vasculitis" 1 => "Antineutophil cytoplasmic antibodies" 2 => "Proteinase 3" 3 => "Myeloperoxidase" 4 => "Antinuclear antibodies" 5 => "Diagnostic value" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec387018" "palabras" => array:6 [ 0 => "Vasculitis" 1 => "Anticuerpos contra el citoplasma del neutrófilo" 2 => "Proteinasa 3" 3 => "Mieloperoxidasa" 4 => "Anticuerpos antinucleares" 5 => "Valor diagnóstico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine positivity and clinical correlation of anti-neutrophil cytoplasmic antibodies (ANCA), taking into account the interference of antinuclear antibodies (ANA).</p> <span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A prospective study was conducted in the Laboratory of Immunology of the National Cuban Center of Medical Genetic during one year. Two hounded sixty-seven patients with indication for ANCA determination were included. ANCA and ANA determinations with different cut off points and assays were determined by indirect immunofluorescense. Anti proteinase 3 and antimyeloperoxidase antibodies were determined by ELISA.</p> <span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Most positivity for ANCA was seen in patients with ANCA associated, primary small-vessel vasculitides, rheumatoid arthritis and systemic lupus erythematosus. Presence of ANCA without positivity for proteinase 3 and myeloperoxidase was higher in patients with ANA and little relation was observed between the perinuclear pattern confirmed in formalin and specificity by myeloperoxidase. Highest sensibility and specificity values for vasculitides diagnostic were achieved by ANCA determination using indirect immunofluorescense with a cut off 1/80 and confirming antigenic specificities with ELISA.</p> <span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">ANCA can be present in a great number of chronic inflammatory or autoimmune disorders in the population studied. This determination using indirect immunofluorescence and following by ELISA had a great value for vasculitis diagnosis. Anti mieloperoxidasa assay has a higher utility than the formalin assay when ANA is present.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar la positividad y la correlación clínica de los anticuerpos contra el citoplasma del neutrófilo (ANCA), teniendo en cuenta la interferencia de los anticuerpos antinucleares (ANA).</p> <span class="elsevierStyleSectionTitle" id="sect0040">Material y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se realizó un estudio prospectivo en el Laboratorio de Inmunología del Centro Nacional de Genética Médica de Cuba durante un año. Se incluyó a 267 pacientes con indicación de ANCA. Las determinaciones de ANCA a diferentes puntos de corte y de ANA se realizaron mediante inmunofluorescencia indirecta. Los anticuerpos antiproteinasa 3 y antimieloperoxidasa fueron determinados mediante ELISA.</p> <span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Nuestro estudio mostró que la mayor positividad de ANCA fue vista en pacientes con vasculitis asociadas a ANCA, artritis reumatoidea y lupus eritematoso sistémico. Fue superior la presencia de ANCA sin especificidad por la proteinasa 3 o la mieloperoxidasa en pacientes con ANA y se observó poca relación entre el patrón perinuclear confirmado en formalina y la presencia de anticuerpos frente a la mieloperoxidasa. Los mayores valores de sensibilidad y especificidad para el diagnóstico de las vasculitis se alcanzaron para la determinación de ANCA mediante inmunofluorescencia indirecta a un valor de corte de 1/80 y confirmando la especificidad antigénica mediante ELISA.</p> <span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los ANCA pueden estar presentes en un amplio número de enfermedades asociadas a estados inflamatorios y autoinmunes en la población estudiada. Su determinación mediante inmunofluorescencia indirecta seguida de la determinación mediante ELISA tiene gran valor para el diagnóstico de las vasculitis. La determinación de anticuerpos antimieloperoxidasa tiene mayor utilidad que el ensayo en láminas de formalina cuando hay ANA.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Martínez Téllez G, Torres Rives B, Rangel Velázquez S, Sánchez Rodríguez V, Ramos Ríos MA, Fuentes Smith LE. Anticuerpos contra el citoplasma del neutrófilo: positividad y correlación clínica. Reumatol Clin. 2015;11:17–21.</p>" ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1094 "Ancho" => 1597 "Tamanyo" => 151376 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">ROC obtained with the determination of antibodies against neutrophil cytoplasm by IIF at different cutoff points and confirmation of antigenic specificities by ELISA in patients negative for antinuclear antibodies. ELISA: enzyme-linked immunosorbent assay; IIF: indirect immunofluorescence.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">ANA−: absence of antinuclear antibodies; ANA: antinuclear antibodies; ANCA: antibodies against neutrophil cytoplasm.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col">Diagnosis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Number of patients (%)</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ANA− \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ANA+ \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Rheumatoid arthritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">91 (34) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">78 (67) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Systemic lupus erythematosus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 (20) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Suspected systemic lupus erythematosus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">ANCA-associated vasculitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Granulomatosis with polyangiitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Eosinophilic granulomatosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Microscopic polyangiitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Suspected ANCA associated vasculitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Scleroderma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Viral Hepatitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mixed connective tissue disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Autoimmune hepatitis type <span class="elsevierStyleSmallCaps">I</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sjögren's syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (1.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ulcerative Colitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (1.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Raynaud's Phenomenon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (1.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Dermatomyositis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Primary biliary cirrhosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Spondyloarthropathy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">267 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">150 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">117 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab639748.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Number of Patients Included in the Study With Positive Antinuclear Antibody.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">ANCA: antineutrophil cytoplasmic antibodies; cANCA: cytoplasmic ANCA pattern; MPO: myeloperoxidase; pANCA: perinuclear ANCA pattern; PR3: proteinase 3.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col">Clinical diagnosis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Number of patients (%)</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">ANCA \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Ethanol</th><th class="td" title="table-head " align="left" valign="top" scope="col">Formalin cANCA \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">PR3 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">MPO \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">cANCA \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">pANCA \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Systemic lupus erythematosus confirmed</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Suspected systemic lupus erythematosus</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">ANCA-associated vasculitis</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Granulomatosis with polyangiitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>eosinophilic granulomatosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Suspected ANCA associated vasculitis</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Rheumatoid arthritis</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Viral Hepatitis</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Scleroderma</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Mixed connective tissue disease</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Sjögren's syndrome</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Autoimmune hepatitis type <span class="elsevierStyleSmallCaps">i</span></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Ulcerative Colitis</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (67) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (33) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Total</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab639749.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Positivity of Antibodies Against Neutrophil Cytoplasm Considering the Clinical Diagnosis of Patients Without Antinuclear Antibodies.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ANCA: antineutrophil cytoplasmic antibodies; cANCA: cytoplasmic ANCA pattern; pANCA: perinuclear ANCA pattern.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col">Clinical diagnosis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Number of patients (%)</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">ANCA \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Ethanol</th><th class="td" title="table-head " align="left" valign="top" scope="col">Formalin cANCA \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">cANCA \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">pANCA \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Systemic lupus erythematosus confirmed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Suspected ANCA associated vasculitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Rheumatoid arthritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49 (63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (10) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Autoimmune hepatitis type <span class="elsevierStyleSmallCaps">I</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5700 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8. \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab639751.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Positivity of Anti-Neutrophil Cytoplasm Antibodies Considering the Clinical Diagnosis of the Patients for Anti-Nuclear Antibodies..</p>" ] ] 4 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">ANCA: antineutrophil cytoplasmic antibodies; E: specificity; ELISA enzyme-linked immunosorbent assay; IIF: indirect immunofluorescence; SLE: systemic lupus erythematosus; S: sensitivity.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col">Diagnosis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="8" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Cutoff in IIF</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">IIF and ELISA</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">1/20</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">1/40</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">1/80</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">1/160</th><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">E (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">SLE confirmed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">89 out of 10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">ANCA-associated vasculitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">79 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">98 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Rheumatoid arthritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Viral Hepatitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Scleroderma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">91 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mixed connective tissue disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sjögren's syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Autoimmune hepatitis type <span class="elsevierStyleSmallCaps">I</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ulcerative Colitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">94 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab639750.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Values of Sensitivity and Specificity Obtained With Different Cutoffs in Determining Antibodies Against Neutrophil Cytoplasm in Antinuclear Antibody Negative Patients.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Jennette" 1 => "R. Falk" 2 => "P. Bacon" 3 => "N. Basu" 4 => "M. Cid" 5 => "F. Ferrairo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/art.37715" "Revista" => array:6 [ "tituloSerie" => "Arthritis Rheum" "fecha" => "2012" "volumen" => "65" "paginaInicial" => "1" "paginaFinal" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23045170" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Utilidad de los anticuerpos anticitoplasma de neutrófilo en reumatología" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L.F. Flores-Suárez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2012.03.002" "Revista" => array:6 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2012" "volumen" => "8" "paginaInicial" => "351" "paginaFinal" => "357" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22673387" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Técnicas inmunológicas que apoyan el diagnóstico de las enfermedades autoinmunes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Hernández" 1 => "J. Cabiedes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2009.10.003" "Revista" => array:6 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2010" "volumen" => "6" "paginaInicial" => "173" "paginaFinal" => "177" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21794705" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Review article: antineutrophil cytoplasmic antibody in small vessel vasculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Nakano" 1 => "S. Ozaki" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rinsho Byori" "fecha" => "2010" "volumen" => "58" "paginaInicial" => "480" "paginaFinal" => "489" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20560457" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update on vasculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Khasnis" 1 => "C.A. Langford" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaci.2009.04.024" "Revista" => array:6 [ "tituloSerie" => "J Allergy Clin Immunol" "fecha" => "2009" "volumen" => "123" "paginaInicial" => "1226" "paginaFinal" => "1236" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19501230" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Testing on formalin-fixed neutrophils is less sensitive and specific for small vessel vasculitis, and less sensitive for MPO-ANCA, than most ELISA" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Australasian ANCA Study Group" "etal" => false "autores" => array:3 [ 0 => "W. Pollock" 1 => "M. Trevisin" 2 => "J. Savige" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Immunol Meth" "fecha" => "2008" "volumen" => "339" "paginaInicial" => "141" "paginaFinal" => "145" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fifty years of antineutrophil cytoplasmic antibodies (ANCA) testing: do we need to revise the international consensus statement on testing and reporting on ANCA?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.W. Cohen Tervaert" 1 => "J. Damoiseaux" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "APMIS" "fecha" => "2009" "volumen" => "117" "paginaInicial" => "55" "paginaFinal" => "59" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Proteinase-3 antineutrophil cytoplasm antibody positivity in patients without primary systemic vasculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.P. McAdoo" 1 => "A. Hall" 2 => "J. Levy" 3 => "A.D. Salama" 4 => "C.D. Pusey" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RHU.0b013e31826d2005" "Revista" => array:6 [ "tituloSerie" => "J Clin Rheumatol" "fecha" => "2012" "volumen" => "18" "paginaInicial" => "336" "paginaFinal" => "340" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23047533" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anticuerpos frente al citoplasma de los neutrófilos (ANCA): correlaciones clínico-patológicas de una serie de 82 casos" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Calvo" 1 => "J. Romero" 2 => "J.C. Arévalo" 3 => "J.L. Ramos" 4 => "E. Doblaré" 5 => "M.L. Vargas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Ann Med Interna" "fecha" => "2002" "paginaInicial" => "2002" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antibodies to selected minor target antigens in patients with anti-neutrophil cytoplasmic antibodies (ANCA)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.V. Talor" 1 => "H. Stone" 2 => "J. Stebbing" 3 => "N. Barin" 4 => "R. Rose" 5 => "C.L. Burek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2249.2007.03453.x" "Revista" => array:7 [ "tituloSerie" => "Clin Exp Immunol" "fecha" => "2007" "volumen" => "150" "paginaInicial" => "42" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17614969" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673600022613" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bacterial endocarditis associated with proteinase 3 anti-neutrophil cytoplasm antibody" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.P. McAdoo" 1 => "C. Densem" 2 => "A. Salama" 3 => "C.D. Pusey" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndtplus/sfr030" "Revista" => array:6 [ "tituloSerie" => "NDT Plus" "fecha" => "2011" "volumen" => "4" "paginaInicial" => "208" "paginaFinal" => "210" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23227113" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antineutrophil cytoplasm autoantibodies in patients with tuberculosis are directed against bactericidal/permeability increasing protein and are detected after treatment initiation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.A. Esquivel-Valerio" 1 => "L.F. Flores-Suarez" 2 => "J. Rodríguez-Amado" 3 => "M.A. Garza-Elizondo" 4 => "A. Rendón" 5 => "M.C. Salinas-Carmona" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Clin Exp Rheumatol" "fecha" => "2010" "volumen" => "28" "paginaInicial" => "35" "paginaFinal" => "39" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20412700" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673602114024" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.T. Masi" 1 => "G.G. Hunder" 2 => "J.T. Lie" 3 => "B.A. Michel" 4 => "D.A. Bloch" 5 => "W.P. Arend" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arthritis Rheum" "fecha" => "1990" "volumen" => "33" "paginaInicial" => "1094" "paginaFinal" => "1100" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2202307" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.Y. Leavitt" 1 => "A.S. Fauci" 2 => "D.A. Bloch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arthritis Rheum" "fecha" => "1990" "volumen" => "33" "paginaInicial" => "1101" "paginaFinal" => "1107" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2202308" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nomenclature of systemic vasculitis. Proposal of an international consensus conference" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.C. Jennette" 1 => "R.J. Falk" 2 => "K. Andrassy" 3 => "P.A. Bacon" 4 => "J. Churg" 5 => "W.L. Gross" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arthritis Rheum" "fecha" => "1994" "volumen" => "37" "paginaInicial" => "187" "paginaFinal" => "192" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8129773" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delineation of a standard procedure for indirect immunofluorescence detection of ANCA" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Wiik" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "APMIS" "fecha" => "1989" "volumen" => "97" "paginaInicial" => "12" "paginaFinal" => "13" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ethical principles for medical research involving human subjects. World Medical Association" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "World Medical Association Declaration of Helsinki" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Bull World Health Org" "fecha" => "2001" "volumen" => "79" "paginaInicial" => "373" "paginaFinal" => "374" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11357217" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anticuerpos antinucleares" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Cabiedes" 1 => "C.A. Núñez-Álvarez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2009.10.004" "Revista" => array:6 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2010" "volumen" => "6" "paginaInicial" => "224" "paginaFinal" => "230" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21794718" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoantibodies in systemic lupus erythematosus: comparison of historical and current assessment of seropositivity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Ippolito" 1 => "D.J. Wallace" 2 => "D. Gladman" 3 => "P.R. Fortin" 4 => "M. Urowitz" 5 => "V. Werth" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0961203310385738" "Revista" => array:6 [ "tituloSerie" => "Lupus" "fecha" => "2011" "volumen" => "20" "paginaInicial" => "250" "paginaFinal" => "255" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21362750" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neutrophil-specific antinuclear and anti-cytoplasmic antibodies in chronic inflammatory diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Wiik" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Autoantibodies" "paginaInicial" => "111" "paginaFinal" => "117" "serieFecha" => "2007" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic value of antineutophil cytoplasmic antibodies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Zak-Go¿ab" 1 => "A. Hrycek" 2 => "M. Holecki" 3 => "J. Chudek" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Wiad Lek" "fecha" => "2011" "volumen" => "64" "paginaInicial" => "37" "paginaFinal" => "42" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21812362" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antineutrophil cytoplasmic antibodies against myeloperoxidase, proteinase 3, elastase, cathepsin G and lactoferrin in Japanese patients with rheumatoid arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Kida" 1 => "S. Kobayashi" 2 => "K. Takeuchi" 3 => "H. Tsuda" 4 => "H. Hashimoto" 5 => "Y. Takasaki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10165-010-0356-9" "Revista" => array:6 [ "tituloSerie" => "Mod Rheumatol" "fecha" => "2011" "volumen" => "21" "paginaInicial" => "43" "paginaFinal" => "50" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20878344" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathogenesis of antineutrophil cytoplasmic autoantibody vasculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.C. Jennette" 1 => "R.J. Falk" 2 => "A.H. Gasim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MNH.0b013e3283456731" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Nephrol Hypertens" "fecha" => "2011" "volumen" => "20" "paginaInicial" => "263" "paginaFinal" => "270" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21422922" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001100000001/v1_201501160858/S2173574314001166/v1_201501160858/en/main.assets" "Apartado" => array:4 [ "identificador" => "17338" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Original Article" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001100000001/v1_201501160858/S2173574314001166/v1_201501160858/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001166?idApp=UINPBA00004M" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 16 | 7 | 23 |
| 2024 October | 163 | 40 | 203 |
| 2024 September | 329 | 33 | 362 |
| 2024 August | 351 | 48 | 399 |
| 2024 July | 445 | 50 | 495 |
| 2024 June | 380 | 40 | 420 |
| 2024 May | 375 | 43 | 418 |
| 2024 April | 286 | 32 | 318 |
| 2024 March | 254 | 40 | 294 |
| 2024 February | 223 | 35 | 258 |
| 2024 January | 203 | 20 | 223 |
| 2023 December | 194 | 31 | 225 |
| 2023 November | 237 | 34 | 271 |
| 2023 October | 247 | 48 | 295 |
| 2023 September | 321 | 55 | 376 |
| 2023 August | 157 | 36 | 193 |
| 2023 July | 137 | 26 | 163 |
| 2023 June | 159 | 32 | 191 |
| 2023 May | 165 | 31 | 196 |
| 2023 April | 138 | 11 | 149 |
| 2023 March | 230 | 25 | 255 |
| 2023 February | 176 | 30 | 206 |
| 2023 January | 158 | 14 | 172 |
| 2022 December | 186 | 36 | 222 |
| 2022 November | 182 | 32 | 214 |
| 2022 October | 106 | 48 | 154 |
| 2022 September | 142 | 43 | 185 |
| 2022 August | 131 | 40 | 171 |
| 2022 July | 92 | 44 | 136 |
| 2022 June | 77 | 38 | 115 |
| 2022 May | 93 | 59 | 152 |
| 2022 April | 140 | 57 | 197 |
| 2022 March | 129 | 73 | 202 |
| 2022 February | 76 | 37 | 113 |
| 2022 January | 80 | 38 | 118 |
| 2021 December | 45 | 33 | 78 |
| 2021 November | 52 | 40 | 92 |
| 2021 October | 85 | 49 | 134 |
| 2021 September | 62 | 40 | 102 |
| 2021 August | 74 | 48 | 122 |
| 2021 July | 112 | 33 | 145 |
| 2021 June | 71 | 33 | 104 |
| 2021 May | 107 | 52 | 159 |
| 2021 April | 272 | 141 | 413 |
| 2021 March | 116 | 44 | 160 |
| 2021 February | 81 | 21 | 102 |
| 2021 January | 77 | 31 | 108 |
| 2020 December | 64 | 23 | 87 |
| 2020 November | 62 | 33 | 95 |
| 2020 October | 36 | 11 | 47 |
| 2020 September | 43 | 23 | 66 |
| 2020 August | 39 | 19 | 58 |
| 2020 July | 28 | 25 | 53 |
| 2020 June | 32 | 17 | 49 |
| 2020 May | 42 | 25 | 67 |
| 2020 April | 39 | 25 | 64 |
| 2020 March | 18 | 7 | 25 |
| 2018 May | 6 | 0 | 6 |
| 2018 April | 81 | 17 | 98 |
| 2018 March | 95 | 9 | 104 |
| 2018 February | 31 | 3 | 34 |
| 2018 January | 42 | 5 | 47 |
| 2017 December | 35 | 9 | 44 |
| 2017 November | 49 | 16 | 65 |
| 2017 October | 37 | 10 | 47 |
| 2017 September | 54 | 11 | 65 |
| 2017 August | 77 | 23 | 100 |
| 2017 July | 61 | 9 | 70 |
| 2017 June | 74 | 18 | 92 |
| 2017 May | 82 | 15 | 97 |
| 2017 April | 50 | 17 | 67 |
| 2017 March | 56 | 14 | 70 |
| 2017 February | 63 | 7 | 70 |
| 2017 January | 63 | 8 | 71 |
| 2016 December | 97 | 38 | 135 |
| 2016 November | 87 | 20 | 107 |
| 2016 October | 104 | 12 | 116 |
| 2016 September | 121 | 12 | 133 |
| 2016 August | 90 | 6 | 96 |
| 2016 July | 49 | 7 | 56 |
| 2016 January | 1 | 0 | 1 |
| 2015 December | 1 | 0 | 1 |
| 2015 September | 2 | 0 | 2 |
| 2015 August | 1 | 0 | 1 |
| 2015 July | 32 | 11 | 43 |
| 2015 June | 71 | 23 | 94 |
| 2015 May | 89 | 21 | 110 |
| 2015 April | 125 | 16 | 141 |
| 2015 March | 214 | 25 | 239 |
| 2015 February | 127 | 13 | 140 |
| 2015 January | 55 | 11 | 66 |
Show all
