Statistics

 array:24 [
  "pii" => "S2173574319301790"
  "issn" => "21735743"
  "doi" => "10.1016/j.reumae.2018.09.015"
  "estado" => "S300"
  "fechaPublicacion" => "2020-11-01"
  "aid" => "1284"
  "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología"
  "copyrightAnyo" => "2018"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Reumatol Clin. 2020;16:473-9"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S1699258X18302213"
      "issn" => "1699258X"
      "doi" => "10.1016/j.reuma.2018.09.007"
      "estado" => "S300"
      "fechaPublicacion" => "2020-11-01"
      "aid" => "1284"
      "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Reumatol Clin. 2020;16:473-9"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 23
        "formatos" => array:2 [
          "HTML" => 15
          "PDF" => 8
        ]
      ]
      "es" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Frecuencia de ANCA positivos en una poblaci&#243;n con s&#237;ntomas cl&#237;nicos sugestivos de enfermedad autoinmune y la interferencia de ANA en su interpretaci&#243;n"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "473"
            "paginaFinal" => "479"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Frequency of Positive ANCA Test in a Population With Clinical Symptoms Suggestive of Autoimmune Disease and the Interference of ANA in its Interpretation"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Consuelo Romero-S&#225;nchez, Mario Benavides-Solarte, Isabel Galindo-Ib&#225;&#241;ez, Ana Isabel Ospina-Caicedo, Viviana Parra-Izquierdo, Lorena Chila-Moreno, Amanda Villa, Mar&#237;a Consuelo Casas-G&#243;mez, Ignacio Angarita, Wilson Bautista-Molano, Ver&#243;nica Romero-&#193;lvarez, Juan Manuel Bello-Gualtero"
            "autores" => array:12 [
              0 => array:2 [
                "nombre" => "Consuelo"
                "apellidos" => "Romero-S&#225;nchez"
              ]
              1 => array:2 [
                "nombre" => "Mario"
                "apellidos" => "Benavides-Solarte"
              ]
              2 => array:2 [
                "nombre" => "Isabel"
                "apellidos" => "Galindo-Ib&#225;&#241;ez"
              ]
              3 => array:2 [
                "nombre" => "Ana Isabel"
                "apellidos" => "Ospina-Caicedo"
              ]
              4 => array:2 [
                "nombre" => "Viviana"
                "apellidos" => "Parra-Izquierdo"
              ]
              5 => array:2 [
                "nombre" => "Lorena"
                "apellidos" => "Chila-Moreno"
              ]
              6 => array:2 [
                "nombre" => "Amanda"
                "apellidos" => "Villa"
              ]
              7 => array:2 [
                "nombre" => "Mar&#237;a Consuelo"
                "apellidos" => "Casas-G&#243;mez"
              ]
              8 => array:2 [
                "nombre" => "Ignacio"
                "apellidos" => "Angarita"
              ]
              9 => array:2 [
                "nombre" => "Wilson"
                "apellidos" => "Bautista-Molano"
              ]
              10 => array:2 [
                "nombre" => "Ver&#243;nica"
                "apellidos" => "Romero-&#193;lvarez"
              ]
              11 => array:2 [
                "nombre" => "Juan Manuel"
                "apellidos" => "Bello-Gualtero"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173574319301790"
          "doi" => "10.1016/j.reumae.2018.09.015"
          "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/S2173574319301790?idApp=UINPBA00004M"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X18302213?idApp=UINPBA00004M"
      "url" => "/1699258X/0000001600000006/v1_202010290752/S1699258X18302213/v1_202010290752/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173574320301209"
    "issn" => "21735743"
    "doi" => "10.1016/j.reumae.2018.11.021"
    "estado" => "S300"
    "fechaPublicacion" => "2020-11-01"
    "aid" => "1299"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Reumatolog&#237;a y Colegio Mexicano de Reumatolog&#237;a"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Reumatol Clin. 2020;16:480-4"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Brief Report</span>"
      "titulo" => "Multiple vertebral fractures following discontinuation of denosumab treatment&#58; ten clinical cases report"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "480"
          "paginaFinal" => "484"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Fracturas vertebrales m&#250;ltiples tras la suspensi&#243;n de tratamiento con denosumab&#58; serie de diez casos"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0010"
          "etiqueta" => "Fig&#46; 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1416
              "Ancho" => 1500
              "Tamanyo" => 172014
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0010"
              "detalle" => "Fig&#46; "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">MR images of case 9 taken 9 months after discontinuation of Denosumab&#44; in T1 &#40;A&#41; and STIR sequences &#40;B&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Elisa Fern&#225;ndez Fern&#225;ndez, Diego Benavent N&#250;&#241;ez, Gema Bonilla Hern&#225;n, Irene Monjo Henry, Sara Garc&#237;a Carazo, Miguel Bernad Pineda, Alejandro Balsa Criado, Pilar Aguado Ac&#237;n"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "Elisa"
              "apellidos" => "Fern&#225;ndez Fern&#225;ndez"
            ]
            1 => array:2 [
              "nombre" => "Diego"
              "apellidos" => "Benavent N&#250;&#241;ez"
            ]
            2 => array:2 [
              "nombre" => "Gema"
              "apellidos" => "Bonilla Hern&#225;n"
            ]
            3 => array:2 [
              "nombre" => "Irene"
              "apellidos" => "Monjo Henry"
            ]
            4 => array:2 [
              "nombre" => "Sara"
              "apellidos" => "Garc&#237;a Carazo"
            ]
            5 => array:2 [
              "nombre" => "Miguel"
              "apellidos" => "Bernad Pineda"
            ]
            6 => array:2 [
              "nombre" => "Alejandro"
              "apellidos" => "Balsa Criado"
            ]
            7 => array:2 [
              "nombre" => "Pilar"
              "apellidos" => "Aguado Ac&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1699258X18302535"
        "doi" => "10.1016/j.reuma.2018.11.002"
        "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/S1699258X18302535?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574320301209?idApp=UINPBA00004M"
    "url" => "/21735743/0000001600000006/v1_202011251719/S2173574320301209/v1_202011251719/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173574320301210"
    "issn" => "21735743"
    "doi" => "10.1016/j.reumae.2018.10.027"
    "estado" => "S300"
    "fechaPublicacion" => "2020-11-01"
    "aid" => "1289"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Reumatolog&#237;a y Colegio Mexicano de Reumatolog&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Reumatol Clin. 2020;16:468-72"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Pulmonary Sarcoidosis&#58; Prognostic Factors at Diagnosis in Patients from North of Portugal"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "468"
          "paginaFinal" => "472"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Sarcoidosis pulmonar&#58; factores pron&#243;sticos en el diagn&#243;stico en enfermos del norte de Portugal"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Lu&#237;sa Silva, Natalia Melo, Patricia Caetano Mota, Bruno Lima, Jos&#233; Miguel Pereira, Rui Cunha, Susana Guimar&#227;es, Concei&#231;&#227;o Souto-Moura, Antonio Morais"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Ana Lu&#237;sa"
              "apellidos" => "Silva"
            ]
            1 => array:2 [
              "nombre" => "Natalia"
              "apellidos" => "Melo"
            ]
            2 => array:2 [
              "nombre" => "Patricia"
              "apellidos" => "Caetano Mota"
            ]
            3 => array:2 [
              "nombre" => "Bruno"
              "apellidos" => "Lima"
            ]
            4 => array:2 [
              "nombre" => "Jos&#233; Miguel"
              "apellidos" => "Pereira"
            ]
            5 => array:2 [
              "nombre" => "Rui"
              "apellidos" => "Cunha"
            ]
            6 => array:2 [
              "nombre" => "Susana"
              "apellidos" => "Guimar&#227;es"
            ]
            7 => array:2 [
              "nombre" => "Concei&#231;&#227;o"
              "apellidos" => "Souto-Moura"
            ]
            8 => array:2 [
              "nombre" => "Antonio"
              "apellidos" => "Morais"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574320301210?idApp=UINPBA00004M"
    "url" => "/21735743/0000001600000006/v1_202011251719/S2173574320301210/v1_202011251719/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Frequency of positive ANCA test in a population with clinical symptoms suggestive of autoimmune disease and the interference of ANA in its interpretation"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "473"
        "paginaFinal" => "479"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Consuelo Romero-S&#225;nchez, Mario Benavides-Solarte, Isabel Galindo-Ib&#225;&#241;ez, Ana Isabel Ospina-Caicedo, Viviana Parra-Izquierdo, Lorena Chila-Moreno, Amanda Villa, Mar&#237;a Consuelo Casas-G&#243;mez, Ignacio Angarita, Wilson Bautista-Molano, Ver&#243;nica Romero-&#193;lvarez, Juan Manuel Bello-Gualtero"
        "autores" => array:12 [
          0 => array:4 [
            "nombre" => "Consuelo"
            "apellidos" => "Romero-S&#225;nchez"
            "email" => array:1 [
              0 => "romeromaria@unbosque.edu.co"
            ]
            "referencia" => array:5 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              3 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
              4 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Mario"
            "apellidos" => "Benavides-Solarte"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Isabel"
            "apellidos" => "Galindo-Ib&#225;&#241;ez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Ana Isabel"
            "apellidos" => "Ospina-Caicedo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Viviana"
            "apellidos" => "Parra-Izquierdo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Lorena"
            "apellidos" => "Chila-Moreno"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Amanda"
            "apellidos" => "Villa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Mar&#237;a Consuelo"
            "apellidos" => "Casas-G&#243;mez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Ignacio"
            "apellidos" => "Angarita"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Wilson"
            "apellidos" => "Bautista-Molano"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          10 => array:3 [
            "nombre" => "Ver&#243;nica"
            "apellidos" => "Romero-&#193;lvarez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          11 => array:3 [
            "nombre" => "Juan Manuel"
            "apellidos" => "Bello-Gualtero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:5 [
          0 => array:3 [
            "entidad" => "Servicio de Reumatolog&#237;a e Inmunolog&#237;a&#44; Hospital Militar Central&#44; Facultad de Medicina&#44; Grupo de Inmunolog&#237;a Cl&#237;nica Aplicada&#44; Universidad Militar Nueva Granada&#44; Bogot&#225;&#44; Colombia"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Facultad de Medicina&#44; Programa de Reumatolog&#237;a&#44; Universidad de la Sabana&#44; Ch&#237;a&#44; Colombia"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Instituto de Referencia Andino&#44; Bogot&#225;&#44; Colombia"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Instituto UIBO&#44; Universidad El Bosque&#44; Bogot&#225;&#44; Colombia"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Facultad de Ciencias B&#225;sicas&#44; Universidad Colegio Mayor de Cundinamarca&#44; Bogot&#225;&#44; Colombia"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Frecuencia de ANCA positivos en una poblaci&#243;n con s&#237;ntomas cl&#237;nicos sugestivos de enfermedad autoinmune y la interferencia de ANA en su interpretaci&#243;n"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Anti-neutrophil cytoplasmic antibodies &#40;ANCA&#41; target primary neutrophil and monocyte granules&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Towards 1985&#44; ANCA were associated with vasculitis such as granulomatosis with polyangiitis &#40;GPA&#41;&#44; formerly called Wegener&#39;s granulomatosis&#44; among others including a large number of inflammatory and infectious diseases&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a> ANCA testing has become an established diagnostic aid for evaluating small vessel necrotising vasculitis&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">There are traditionally 2 methods for determining the presence of ANCA&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The most commonly used method is the indirect immunofluorescence assay &#40;IIF&#41;&#44; defining two main patterns&#58; C-ANCA&#44; which has a cytoplasmic pattern and most target proteinase 3 &#40;PR3&#41; and P-ANCA&#44; which has a perinuclear pattern and target myeloperoxidase &#40;MPO&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> However&#44; this methodology has drawbacks when differentiating between P-ANCA and C-ANCA patterns when it is next to antinuclear antibodies &#40;ANA&#41;&#46; Due to this interference&#44; ANA determination in conjunction with ANCA<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and the presence of ANCA targeting antigens other than MPO or PR3 are important&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The second method for specific testing is the enzyme-linked immunosorbent assay &#40;ELISA&#41;&#44; which identifies antibodies that target specific antigens such as PR3 and MPO&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a> The sensitivity of the IIF is between 80&#37; and 90&#37; while its specificity is less than 80&#37; due to the presence of P-ANCA targeting antigens other than MPO&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> For this reason&#44; the ANCA consensus suggests using the IIF technique as screening and then performing a confirmatory test against specific antigens by means of ELISA&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Another test has recently emerged that uses IIF to test for ANCA called <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span>&#59; this test contains human granulocytes fixed in ethanol and also integrates microparticles coated with PR3 antigen and MPO as substrate&#44; generating their specific identification and has become a good alternative to consider in identifying ANCA since it has optimal sensitivity and specificity in one test&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#8211;14</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">For this reason&#44; the main objective of this study was to determine the frequency of positive ANCA in a population with manifestations of autoimmune disease&#59; and to evaluate the interference of ANA in their interpretation&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Materials and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">A retrospective&#44; descriptive&#44; non-experimental cross-sectional study&#46; We have included 3330 pieces of data collected from patients with a presumptive or suspected diagnosis of autoimmune disease and request for ANCA between 2013 and 2015&#44; referred to the <span class="elsevierStyleItalic">Hospital Militar Central</span> and the <span class="elsevierStyleItalic">Instituto de Referencia Andino</span>&#46; In addition&#44; to compare the performance of 3 methods&#44; 44 samples were selected with a previous ANCA request where the presence of ANCA and ANA was determined simultaneously by means of different methodologies using the <span class="elsevierStyleItalic">L-ANCA</span>&#174;&#44; <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> kits&#44; and anti-PR3 and anti-MPO by ELISA&#46; The project was approved by the Research and Ethics Committee of the <span class="elsevierStyleItalic">Hospital Militar Central</span> &#40;code N 2014-080&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">Demographic characteristics&#44; age&#44; gender and clinical manifestations were analysed by frequency using SPSS V18 for Windows&#44; with a 95&#37; confidence level&#44; and the STATA 11&#174; programme&#44; agreement between the techniques was tested by the Kappa coefficient&#46; The frequency of signs and symptoms and the clinical areas referring the request were established&#46; ANCA positivity was then distributed according to the clinical manifestations of autoimmune disease&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090"><span class="elsevierStyleItalic">L-ANCA</span>&#174; &#40;Ref&#46; 10070-L-11&#44; Immunoconcepts&#174;&#41;</span><p id="par0040" class="elsevierStylePara elsevierViewall">All the serum samples were adjusted to a 1&#58;20 dilution&#46; The <span class="elsevierStyleItalic">L-ANCA</span>&#174; test contains granulocytes and a lymphocyte content&#44; which when viewed under the microscope will indicate the presence of positive ANA in the samples simultaneously with ANCA &#8211; if positive&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> Only the presence of ANA was reported without identifying the pattern in the case of positivity&#44; given the cell substrate used&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095"><span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> &#40;Ref&#46; 8063&#46;GA Generic Assays&#41;</span><p id="par0045" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> kit is a multiplex assay containing human granulocytes fixed in ethanol as well as microparticles coated with PR3 antigen and MPO as substrate which enable the identification of positive ANCA differentiating C-ANCA from P-ANCA specifically&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">ELISA &#40;&#174;Anti PR3 y anti MPO&#44; Ref 4058&#44;4059 Generic Assay GmbH&#41;</span><p id="par0050" class="elsevierStylePara elsevierViewall">IgG antibodies against PR3 and MPO were identified in human serum with positive values above 10<span class="elsevierStyleHsp" style=""></span>IU&#47;ml&#46; Anti-PR3 and anti MPO-ANCA were detected using commercially available antigen-specific ELISAs according to the manufacturer&#39;s instructions&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Description of the sample</span><p id="par0055" class="elsevierStylePara elsevierViewall">We retrospectively analysed 3330 data from patients with an ANCA request&#46; Of the total requests&#44; 1065 &#40;31&#46;9&#37;&#41; corresponded to male patients and 2265 &#40;68&#37;&#41; to female patients&#44; with an average age of 42&#46;08<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&#46; ANCA positivity was evidenced in 10&#46;2&#37; &#40;340&#47;3330&#41; of the requests&#44; of which 40&#37; &#40;136&#47;340&#41; had C-ANCA pattern and 60&#37; &#40;204&#47;340&#41; P-ANCA &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Together with the initial ANCA requests&#44; only 67 of the 3330 had a request for anti-MPO and anti-PR3&#44; of which 62&#46;7&#37; &#40;42&#47;67&#41; had positive ANCA and 11&#46;9&#37; &#40;8&#47;67&#41; were only positive for anti-PR3&#44; 16&#46;4&#37; &#40;11&#47;67&#41; only for anti-MPO and 5&#46;9&#37; &#40;4&#47;67&#41; had mixed positivity&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">ANA were requested with ANCA simultaneously in 538 data&#44; of which 68&#46;2&#37; &#40;367&#41; were positive for ANA only&#44; and a homogeneous pattern was identified in 68&#37; &#40;170&#41;&#44; granular in 24&#46;7&#37; &#40;91&#41;&#44; cytoplasmic in 6&#46;2&#37; &#40;23&#41;&#44; nucleolar in &#46;8&#37; &#40;3&#41; and 21&#46;8&#37; &#40;80&#41; of the results had more than one pattern for ANA&#44; which was termed &#8220;mixed pattern&#8221;&#46; For the positive data&#44; the titre of these antibodies was tested and the most frequent was found to be between 1&#58;80 and 1&#58;160&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">It was found that 12&#46;6&#37; of the data collected retrospectively with positive ANCA also had positive ANA&#59; of these 83&#46;7&#37; corresponded to the P-ANCA pattern and 16&#46;27&#37; to the C-ANCA pattern&#46; In the positive P-ANCA the predominant ANA pattern was the homogeneous pattern followed by the granular pattern&#44; in the C-ANCA the predominant ANA pattern was cytoplasmic followed by granular&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Agreement between techniques</span><p id="par0075" class="elsevierStylePara elsevierViewall">In order to compare the performance of the methods&#44; 44 samples were selected with a previous ANCA request where the presence of ANCA and ANA was determined by means of different methodologies using the abovementioned <span class="elsevierStyleItalic">L-ANCA</span>&#174;&#44; <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> kits and anti-PR3 and anti-MPO by ELISA&#46; This group had a distribution of 77&#46;3&#37; females and 22&#46;8&#37; males&#44; with a mean age of 48&#46;27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&#46;27&#46; Seventy-five percent &#40;33&#47;44&#41; had positive results for previous ANCA&#44; which corresponded to C-ANCA in 36&#46;4&#37; and P-ANCA in 63&#46;6&#37;&#46; In addition&#44; 61&#46;3&#37; &#40;27&#47;44&#41; positivity for ANA was observed&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Thirty-six point four percent &#40;16&#47;44&#41; were positive for ANCA and ANA simultaneously&#44; of which 87&#46;5&#37; &#40;14&#47;16&#41; had a P-ANCA pattern and 12&#46;5&#37; &#40;2&#47;16&#41; C-ANCA&#46; Of the P-ANCA samples only 7 were positive for anti-MPO and 2 for anti-PR3 and the remaining 5 were negative for anti-MPO and anti-PR3&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">When the <span class="elsevierStyleItalic">L-ANCA</span>&#174; technique was used&#44; positivity for ANCA was observed in 59&#46;1&#37; &#40;26&#47;44&#41;&#44; of which 85&#46;8&#37; &#40;23&#47;26&#41; corresponded to the P-ANCA pattern and 11&#46;5&#37; &#40;3&#47;26&#41; to the C-ANCA pattern&#59; 43&#46;2&#37; &#40;19&#47;44&#41; were positive for ANA using the <span class="elsevierStyleItalic">L-ANCA</span>&#174; methodology and 56&#46;8&#37; &#40;25&#47;44&#41; negative&#46; Sixty-one point five percent 61&#46;5&#37; &#40;16&#47;26&#41; were positive for ANCA and ANA at the same time&#44; of which 93&#46;7&#37; &#40;15&#47;16&#41; had a P-ANCA pattern&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">By <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span>&#44; 38&#46;6&#37; &#40;17&#47;44&#41; of the samples were positive for ANCA&#44; and 61&#46;4&#37; &#40;27&#47;44&#41; were negative&#46; In turn&#44; 35&#46;3&#37; &#40;6&#47;17&#41; of the ANCA-positive samples were positive for anti-PR3&#44; 41&#46;2&#37; &#40;7&#47;17&#41; for anti-MPO and 23&#46;5&#37; &#40;4&#47;17&#41; had mixed positivity&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Finally&#44; in the 44 samples with previous ANCA results the concentration of anti-PR3 and anti-MPO was quantified by means of ELISA&#44; obtaining an average of 43&#46;8<span class="elsevierStyleHsp" style=""></span>U&#47;ml for anti-PR3 and 24&#46;7<span class="elsevierStyleHsp" style=""></span>U&#47;ml for anti-MPO&#46; Eighteen positive samples were identified&#44; of which 13&#46;6&#37; &#40;6&#47;44&#41; were anti-PR3 positive&#44; 18&#46;2&#37; &#40;8&#47;44&#41; were MPO positive and 9&#46;1&#37; &#40;4&#47;44&#41; had mixed positivity&#44; with a cut-off point of 10<span class="elsevierStyleHsp" style=""></span>U&#47;ml&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The performance of the difference methods was assessed through a correlation analysis and obtaining the Kappa index for all the cases where ANCA were measured by least 2 of the techniques evaluated&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Agreement in the measurement of anti-PR3 between the <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> technique and ELISA was 100&#37; &#40;<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#44; of which 10 results were positive and 34 negative for both techniques&#44; without differing results &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">When comparing anti-MPO measurement by ELISA against <span class="elsevierStyleItalic">CytoBead ANCA</span>&#44; discrepancy was observed in one result that was negative by <span class="elsevierStyleItalic">CytoBead ANCA</span> and positive by ELISA with a value of 10&#46;1 taking as the benchmark a cut-off point of 10<span class="elsevierStyleHsp" style=""></span>U&#47;ml&#44; nevertheless agreement was high &#40;<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;94&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">A discrepancy was observed in the evaluation between <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> and <span class="elsevierStyleItalic">L-ANCA</span>&#174; in two aspects&#58; first&#44; 14 data that were positive for L-ANCA&#174; were negative for <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span>&#59; second&#44; 5 data negative for <span class="elsevierStyleItalic">L-ANCA</span>&#174; were positive for <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span>&#44; thus obtaining very low agreement &#40;<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;17&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">When comparing the results obtained by <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> with previous ANCA results &#40;taken retrospectively&#41; it was observed that of 27 results that were negative by <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span>&#44; 17 of these had previous positive ANCA and 6 of these had previous positive ANA at the same time&#58; ANA were not technically performed previously in the remaining 11 &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41;&#46; Likewise&#44; of the 18 negative results by <span class="elsevierStyleItalic">L-ANCA</span>&#174;&#44; 16 had previous positive ANCA and 7 of these showed previous positive ANA simultaneously &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;07&#41;&#46; On examining the results obtained by <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span>&#44; <span class="elsevierStyleItalic">L-ANCA</span>&#174; and previous ANCA&#44; only 11 results were observed as positive for the 3 tests&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Finally&#44; the clinical histories of 241 out of the 3330 requests with the most frequent clinical manifestations were reviewed for which ANCA were requested and were categorised in 4 groups&#58; the first had some type of vasculitis&#44; the second an autoimmune disease&#44; the third a non-autoimmune rheumatic disease and the fourth another type of disease &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">ANCA positivity was found in 8&#46;3&#37; &#40;20&#47;241&#41;&#44; for which the P-ANCA pattern was identified in 90&#37; &#40;18&#47;20&#41; and C-ANCA in 10&#37; &#40;2&#47;20&#41;&#46; Of the total requests with a clinical history&#44; positive ANA were found in 35&#37; &#40;85&#47;241&#41; with a homogeneous pattern in 54&#46;1&#37;&#44; granular in 34&#46;1&#37;&#44; cytoplasmic in 10&#46;6&#37; and nucleolar in 1&#46;18&#37;&#46; In the data that were positive for ANCA the simultaneous presence of ANA was identified in 25&#37; &#40;5&#47;20&#41;&#44; with a speckled pattern in 40&#37;&#44; homogeneous in 40&#37; and cytoplasmic in 20&#37;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">On retrospectively making the clinical correlation of the patients with positive ANCA it was found that 30&#37; &#40;6&#47;20&#41; had been diagnosed with vasculitis of some type&#44; 20&#37; &#40;4&#47;20&#41; had an autoimmune disease&#44; 5&#37; &#40;1&#47;20&#41; had non-autoimmune rheumatic disease and 45&#37; &#40;9&#47;20&#41; had another type of disease in the primary assessment according to their clinical history&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">The annual incidence worldwide of vasculitis is approximately 10&#8211;20 cases per million inhabitants with a mortality rate reaching 80&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a> GPA-type vasculitis associated with the presence of ANCA does not have homogeneous geographic distribution and the reported prevalence of ANCA in GPA varies between 50&#37; and 95&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> In the Japanese and Afro-American population the incidence of GPA is lower but there is higher frequency of MPA&#44;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a> by contrast&#44; GPA is more frequent in northern Europe with fewer documented cases of MPA&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a> In Colombia&#44; cases of other subtypes of vasculitis and GPA have been identified&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> It is believed that the low percentage of cases reported with a diagnosis of GPA might be related to the poor referral of these patients to rheumatology departments&#44; and treating physicians and the Ministry of Social Protection failing to record these cases&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">In this study&#44; the results showed positive ANCA in 340 data obtained&#44; of which 136 had a C-ANCA and 204 P-ANCA pattern&#59; however&#44; ANA and antibodies targeting other cytoplasmic granules as antigens &#40;lactoferrin&#44; lysozyme&#44; azurocidin&#44; elastase&#44; cathepsin G&#44; bactericidal growth enzyme&#47;permeability&#41; show atypical ANCA patterns&#44; and these have presented some technical difficulty in being differentiated and can be confused with the P-ANCA pattern&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;22&#44;23</span></a> In our data&#44; 12&#46;6&#37; of patients with ANA simultaneously presented positive ANCA with a homogeneous pattern at low titres in the majority&#46; Despite being one of the most frequent patterns in autoimmune diseases&#44; this group of patients did not have a diagnosis of systemic lupus erythematosus&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#8211;26</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">The results taken retrospectively in our study showed predominance of the P-ANCA pattern in the data that were positive for ANA and ANCA&#44; which has been described in the literature as possible false positives for ANCA by IIF due to interference in the process of binding to the substrate that occurs due to a rearrangement of proteins of the nucleus when the samples are fixed in ethanol&#44; generating diffuse colouration&#59; another interference has been described in results with positive anti-DNA antibodies&#44; which simultaneously evidences a need for experts in the correct reading and interpretation of the ANA and ANCA pattern&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;15</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">The study published by Martinez Tellez et al&#46;&#44; sought to determine the positivity and clinical correlation of ANCA&#44; taking into account the interference of ANA&#59; it was found that the likelihood of finding ANCA is greater in patients with positive ANA&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> The atypical P-ANCA pattern is found in patients with inflammatory bowel disease&#44; predominantly ulcerative colitis&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> In combination with anti-<span class="elsevierStyleItalic">Saccharomyces cerevisiae</span> antibodies&#44; P-ANCA are helpful in the differentiation of ulcerative colitis and Crohn&#39;s disease&#44; the anti-<span class="elsevierStyleItalic">S&#46; cerevisiae</span> antibody being more typical of Crohn&#39;s disease and P-ANCA of ulcerative colitis<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#59; however&#44; the recognised antigen does not target MPO&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">On the other hand&#44; when analysing the data of the 2 new techniques compared to previous ANCA results in the traditional way&#44; it was observed that 36&#46;5&#37; showed positive ANA&#44; and only a small percentage of these showed positive anti-MPO&#46; Again&#44; this could indicate the interference of ANA in reading the ANCA pattern by IIF&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">ELISA is used as a traditional confirmatory test for the IIF technique for ANCA&#44; indirect&#44; quantitative and targeted at PR3 and MPO proteins&#46; The recent <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> kit offers a novel test that covers cells &#40;granulocytes fixed in ethanol&#41; and synthetic microparticles &#40;coated with PR3 and MPO antigens&#41; in the same well&#44; for screening and confirmation of antibodies&#46; Our results found that using this technique38&#46;6&#37; of the samples resulted positive and when confirmation of PR3 was compared with confirmation by ELISA no discrepant results were found&#46; This is considered a very good simultaneous ANCA test alternative using the IIF method without the need for a confirmatory ELISA test&#44; allowing the detection and confirmation of autoantibodies in shorter times&#44; better reproducibility and greater performance in larger samples&#46; This agrees with the study by Sowa et al&#46;&#44; who evaluate the efficacy of this new <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> technique comparing it with the classical tests for ANCA by IIF&#44; PR3 and MPO by ELISA&#44; finding excellent correlation for ANCA PR3 and MPO as well as for P-ANCA and C-ANCA between the classical methods and the multiplex <span class="elsevierStyleItalic">CytoBeads</span>&#174; <span class="elsevierStyleItalic">ANCA&#46;</span><a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;27</span></a> This is in line with the consensus for handling and interpreting ANCA&#44; and IIF is proposed as a screening and confirmatory test due to its high specificity&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">Unlike the results of <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> when comparing the data of the <span class="elsevierStyleItalic">L-ANCA</span>&#174; technique with previous ANCA&#44; a discrepancy in the results was observed resulting in low correlation between the 3 techniques&#46; According to these results it can be inferred that the <span class="elsevierStyleItalic">CytoBeads</span>&#174; <span class="elsevierStyleItalic">ANCA</span> technique performs better than the <span class="elsevierStyleItalic">L-ANCA</span>&#174;&#59; although the latter includes simultaneous assessment of ANA&#44; the results were not satisfactory&#46; In the observations of the parent company it is suggested that the presence of ANA could interfere with the interpretation of ANCA&#46; Staining on the cytoplasm or on the lymphocyte surface did not clearly indicate interference by ANA&#44; the staining observed was not sufficiently sharp in some cases&#46; Therefore&#44; if ANA interference was present&#44; ANCA by immunofluorescence could not be interpreted&#59; thus&#44; assessment of lymphocyte staining did not always indicate the presence of ANA&#44; in addition to not detecting similar ANCA results in some patients on the neutrophils observed by the other methods&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">ANCA are currently useful in the diagnosis and classification of vasculitis&#44; however&#44; their usefulness depends on the prevalence in the study population and clinical presentation&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In rheumatological conditions not associated with vasculitis it is possible to document positivity for ANCA&#44; as in our study&#44; where we found positivity for ANCA in 6&#46;6&#37; of the data related to non-autoimmune rheumatic disease consistent with the presence of ANCA described in different diseases such as primary sclerosing cholangitis&#44; type I autoimmune hepatitis&#44; Felty&#39;s syndrome and inflammatory bowel disease&#46; In the latter&#44; positivity is documented in up to 50&#37;&#8211;70&#37; of patients with ulcerative colitis and in 10&#37;&#8211;30&#37; of individuals with Crohn&#39;s disease and hyperthyroidism&#46; However&#44; their usefulness in these scenarios has not been clearly established&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#8211;34</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">The lack of agreement between clinical data and relevance of ANCA requests in our environment could show the difficulty existing in the different care levels in differentiating the clinical characteristics of vasculitis from other diseases not associated with vasculitis&#46; Thus&#44; in our study&#44; clinical data were obtained from 241 patients&#44; of whom 33&#37; had an initial suspicion of vasculitis&#44; detecting positivity for ANCA in less than 10&#37; of cases&#44; which indicates an overestimation by the health professionals in requesting this diagnostic aid&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Several studies have demonstrated the diagnostic value of ANCA for vasculitis as long as the correct methodology associated with the relevant clinical findings is used&#46; Therefore&#44; ANCA results should always be confirmed by ELISA and it should always be determined whether the patient has positive ANA and ANCA to discount the effect of nucleus staining that generates false ANCA <span class="elsevierStyleItalic">positives</span> and thus make an assertive diagnosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">35&#8211;37</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Since precise detection for PR3-ANCA and MPO-ANCA has important clinical and pathogenic implications&#44; non-targeted request in the different levels of clinical care and reliable immunoassays for PR3-ANCA and MPO-ANCA have become more widespread every day&#46; The results of this study would support the proposal made by the latest international consensus for ANCA tests in granulomatosis and polyangiitis by means of which testing using specific&#44; high quality methods is suggested as the preferred primary method to support the diagnosis of an ANCA-associated vasculitis&#46; This is without the need to use IIF on first line neutrophils as support&#59; however&#44; further evidence and studies are required to support this recommendation&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">38&#44;39</span></a></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusions</span><p id="par0195" class="elsevierStylePara elsevierViewall">ANCA are currently useful as an aid in the diagnosis and classification of vasculitis&#59; however&#44; their value depends on the clinical context&#46; Given that the objective was to determine the frequency of ANCA in a population with manifestations of autoimmune disease&#44; the results indicate overestimated requests for this marker as a diagnostic aid in non-targeted primary care consultation&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Secondly&#44; when evaluating the interference of ANA in the interpretation of ANCA&#44; for the adequate assessment of ANCA&#44; the IIF technique should be implemented in laboratories as screening and confirmed with testing for specific anti-PR3 and anti-MPO antigens by any of the commercially available confirmatory assays&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflict of interests</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres1420635"
          "titulo" => "Abstract"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Background"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Objective"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Materials and methods"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Results"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1299091"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1420636"
          "titulo" => "Resumen"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Antecedentes"
            ]
            1 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Objetivo"
            ]
            2 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Materiales y m&#233;todos"
            ]
            3 => array:2 [
              "identificador" => "abst0045"
              "titulo" => "Resultados"
            ]
            4 => array:2 [
              "identificador" => "abst0050"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1299090"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Materials and methods"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Statistical methods"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "L-ANCA&#174; &#40;Ref&#46; 10070-L-11&#44; Immunoconcepts&#174;&#41;"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "CytoBead&#174; ANCA &#40;Ref&#46; 8063&#46;GA Generic Assays&#41;"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "ELISA &#40;&#174;Anti PR3 y anti MPO&#44; Ref 4058&#44;4059 Generic Assay GmbH&#41;"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0035"
          "titulo" => "Results"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Description of the sample"
            ]
            1 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Agreement between techniques"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Conflict of interests"
        ]
        10 => array:2 [
          "identificador" => "xack495488"
          "titulo" => "Acknowledgements"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2018-03-28"
    "fechaAceptado" => "2018-09-20"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1299091"
          "palabras" => array:3 [
            0 => "Antinuclear antibodies"
            1 => "Antineutrophil cytoplasmic antibodies"
            2 => "Vasculitis"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1299090"
          "palabras" => array:3 [
            0 => "Anticuerpos antinucleares"
            1 => "Anticuerpos anticitoplasma de neutr&#243;filos"
            2 => "Vasculitis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Antibodies against neutrophil cytoplasm &#40;ANCA&#41; are associated with vasculitis&#46; There are different methods to determine their presence&#46; The interference of antinuclear antibodies &#40;ANA&#41; in the differentiation between P-ANCA and C-ANCA patterns has been described&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">To determine the frequency of ANCA in a population with manifestations of autoimmune disease&#44; and evaluate the interference of ANA in its interpretation&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Materials and methods</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Retrospective&#44; descriptive nonexperimental cross-sectional study&#44; including 3330 data&#46; The presumptive diagnosis was autoimmune disease and a test for ANCA was requested&#46; The ANCA and ANA determinations were made by indirect immunofluorescence&#44; L-ANCA&#174; and CytoBead&#174; ANCA&#46; Anti-proteinase 3 and anti-myeloperoxidase were detected by ELISA and CytoBead&#174; ANCA&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">ANCAs were positive in 10&#46;21&#37; and 12&#46;64&#37; of those positive for ANCA were positive for ANA&#46; The inter-rater agreement statistic &#40;Kappa&#41; for anti-PR3 between CytoBead ANCA and ELISA was 100&#37; &#40;<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;00&#59; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41; and the agreement between anti-myeloperoxidase by ELISA and CytoBead&#174; ANCA was high &#40;<span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;94&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; 30&#37; of those with ANCAs had a diagnosis of a type of vasculitis&#59; 20&#37; of them had an autoimmune disease&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">The results suggest an overestimated request for ANCAs as a diagnostic aid in primary care which was not addressed&#46; For an adequate evaluation of ANCAs&#44; the indirect immunofluorescence technique should be implemented for the control and confirmation with the determination of specific antigens for anti-proteinase 3 and anti-myeloperoxidase in any of the confirmatory assays&#46; The high concordance shown by ANCA CytoBeads makes us consider the use of this alternative for the determination of ANCAs and the confirmation&#46; Given the interference of ANAs&#44; the ANA test by IFI in the presence of positive P-ANCA results is recommended in order to minimise &#8220;false positives&#8221;&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objective"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Materials and methods"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Los anticuerpos anticitoplasma del neutr&#243;filo &#40;ANCA&#41; se asocian con vasculitis&#46; Existen diferentes m&#233;todos para determinar su presencia&#46; Se ha descrito la interferencia de anticuerpos antinucleares &#40;ANA&#41; en la diferenciaci&#243;n de los patrones P-ANCA y <span class="elsevierStyleSmallCaps">C</span>-ANCA&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Determinar la frecuencia de ANCA en una poblaci&#243;n con manifestaciones de enfermedad autoinmune&#59; y evaluar la interferencia de los ANA en su interpretaci&#243;n&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Materiales y m&#233;todos</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Estudio de corte transversal retrospectivo&#44; descriptivo no experimental incluyendo 3&#46;330 datos con diagn&#243;stico presuntivo de enfermedad autoinmune y solicitud de ANCA&#46; Las determinaciones de ANCA y de ANA se realizaron mediante inmunofluorescencia indirecta&#44; <span class="elsevierStyleItalic">L-ANCA</span>&#174; y <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span>&#46; Antiproteinasa 3 y antimieloperoxidasa fueron determinados mediante ELISA y <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span>&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Se encontraron ANCA positivos en el 10&#44;21&#37; y el 12&#44;64&#37; con ANCA positivos presentaban ANA positivos&#46; La concordancia kappa para antiproteinasa 3 entre <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> y ELISA fue del 100&#37; &#40;K<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; La concordancia entre antimieloperoxidasa por ELISA y <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span> fue alta &#40;K<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;94&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; El 30&#37; de aquellos con ANCA positivos ten&#237;a diagn&#243;stico de alg&#250;n tipo de vasculitis&#44; el 20&#37; cursaba con alguna enfermedad autoinmune&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Los resultados indican una solicitud sobreestimada de este marcador como ayuda diagn&#243;stica en consulta de atenci&#243;n primaria no direccionada&#46; Para una adecuada evaluaci&#243;n de ANCA se debe implementar la t&#233;cnica de inmunofluorescencia indirecta para tamizaje y confirmar con la determinaci&#243;n de ant&#237;genos espec&#237;ficos para antiproteinasa 3 y antimieloperoxidasa por cualquiera de los ensayos confirmatorios&#46; La alta concordancia mostrada por <span class="elsevierStyleItalic">CytoBeads</span>&#174; <span class="elsevierStyleItalic">ANCA</span> hace que planteemos el empleo de dicha alternativa para la determinaci&#243;n de ANCA y su confirmaci&#243;n&#46; Dada la interferencia de los ANA&#44; se recomienda solicitar la prueba ANA por inmunofluorescencia indirecta ante la presencia de resultados P-ANCA positivos&#44; con el fin de minimizar &#171;falsos positivos&#187;&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Antecedentes"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Materiales y m&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Romero-S&#225;nchez C&#44; Benavides-Solarte M&#44; Galindo-Ib&#225;&#241;ez I&#44; Ospina-Caicedo AI&#44; Parra-Izquierdo V&#44; Chila-Moreno L&#44; et al&#46; Frecuencia de ANCA positivos en una poblaci&#243;n con s&#237;ntomas cl&#237;nicos sugestivos de enfermedad autoinmune y la interferencia de ANA en su interpretaci&#243;n&#46; Reumatol Clin&#46; 2020&#59;16&#58;473&#8211;479&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3330&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Mean age</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#46;08<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sex&#44; N &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;065 &#40;31&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;265 &#40;68&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ANCA&#44; N &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">340 &#40;10&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Negative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;990 &#40;89&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Positive ANCA pattern&#44; N &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>C-ANCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">136 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>P-ANCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">204 &#40;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ANA&#44; N &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">367 &#40;11&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Negative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">171 &#40;5&#46;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Without medical request&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2792 &#40;83&#46;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ANA pattern&#44; N &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Homogeneous pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">170 &#40;46&#46;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Granular pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91 &#40;24&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cytoplasmic pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;6&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nucleolar pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;&#46;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mixed pattern&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80 &#40;21&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">ANA titre&#44; N &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#58;80&#8211;&#60;1&#58;160&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">245 &#40;66&#46;75&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#58;160&#8211;&#60;1&#58;320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65 &#40;17&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#58;320&#8211;&#60;1&#58;640&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49 &#40;13&#46;35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#58;640&#8211;&#60;1&#58;1280&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#46;17&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Anti-MPO&#44; N &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medical request&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 &#40;2&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No request&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3263 &#40;97&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>61&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Anti-PR3&#44; N &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medical request&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 &#40;2&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No request&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;263 &#40;97&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;25<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>109&#46;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2436695.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Demographic and serological variables&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Kappa index&#58; <span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#46;</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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PR3 <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span></th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Negative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="3" align="left" valign="middle">PR3 ELISA</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Negative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2436693.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Agreement between anti-PR3 by ELISA and <span class="elsevierStyleItalic">CytoBead</span>&#174; results&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0035"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Kappa index&#58; <span class="elsevierStyleItalic">K</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;94&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#46;</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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_colgroup " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">MPO <span class="elsevierStyleItalic">CytoBead</span>&#174; <span class="elsevierStyleItalic">ANCA</span></th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Negative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead rowgroup " rowspan="3" align="left" valign="middle">MPO ELISA</td><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Negative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2436694.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Agreement between anti-MPO by ELISA and <span class="elsevierStyleItalic">CytoBead</span>&#174; results&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0040"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Entity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Positive ANCA&#44; <span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#47;241&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Most frequent diseases by group &#40;<span class="elsevierStyleItalic">N</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vasculitis&#44; 30&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#47;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Polyangiitis with granulomatosis &#40;3&#41;Granulomatous eosinophilia &#40;2&#41;Microscopic polyangiitis &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Autoimmune disease&#44; 20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#47;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sj&#246;gren&#39;s syndrome &#40;1&#41;&#44; idiopathic thrombocytopenic purpura &#40;1&#41;&#44; rheumatoid arthritis &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A non-autoimmune rheumatic disease&#44; 5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cryoglobulinaemia &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other type of disease&#44; 45&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#47;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Endocarditis &#40;2&#41;&#44; lymphoma &#40;1&#41;&#44; HIV infection &#40;3&#41;&#44; sarcoidosis &#40;1&#41;&#44; hepatitis C infection &#40;1&#41;&#44; cocaine intoxication &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2436692.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Distribution of diseases with positive ANCA by IIF&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:39 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Segmental necrotising glomerulonephritis with antineutrophil antibody&#58; possible arbovirus aetiology&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;J&#46; Davies"
                            1 => "J&#46;E&#46; Moran"
                            2 => "J&#46;F&#46; Niall"
                            3 => "G&#46;B&#46; Ryan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Br Med J &#40;Clin Res Ed&#41;"
                        "fecha" => "1982"
                        "volumen" => "285"
                        "paginaInicial" => "606"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autoantibodies against neutrophils and monocytes&#58; tool for diagnosis and marker of disease activity in Wegener&#39;s granulomatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;J&#46; Van der Woude"
                            1 => "N&#46; Rasmussen"
                            2 => "S&#46; Lobatto"
                            3 => "A&#46; Wiik"
                            4 => "H&#46; Permin"
                            5 => "L&#46;A&#46; van Es"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(85)91147-X"
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1985"
                        "volumen" => "1"
                        "paginaInicial" => "425"
                        "paginaFinal" => "429"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;C&#46; Jennette"
                            1 => "R&#46;J&#46; Falk"
                            2 => "P&#46;A&#46; Bacon"
                            3 => "N&#46; Basu"
                            4 => "M&#46;C&#46; Cid"
                            5 => "F&#46; Ferrario"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.37715"
                      "Revista" => array:5 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2013"
                        "volumen" => "65"
                        "paginaInicial" => "1"
                        "paginaFinal" => "11"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antineutrophil cytoplasmic antibodies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "X&#46; Bosch"
                            1 => "A&#46; Guilabert"
                            2 => "J&#46; Font"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(06)69114-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2006"
                        "volumen" => "368"
                        "paginaInicial" => "404"
                        "paginaFinal" => "418"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16876669"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Current and emerging techniques for ANCA detection in vasculitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46; Csernok"
                            1 => "F&#46; Moosig"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/nrrheum.2014.78"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Rev Rheumatol"
                        "fecha" => "2014"
                        "volumen" => "10"
                        "paginaInicial" => "494"
                        "paginaFinal" => "501"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24890776"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic predictive value of ANCA serology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;C&#46; Jennette"
                            1 => "A&#46;S&#46; Wilkman"
                            2 => "R&#46;J&#46; Falk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1523-1755.1998.00800.x"
                      "Revista" => array:5 [
                        "tituloSerie" => "Kidney Int"
                        "fecha" => "1998"
                        "volumen" => "53"
                        "paginaInicial" => "796"
                        "paginaFinal" => "798"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antineutrophil cytoplasmic antibodies and associated diseases&#58; a review of the clinical and laboratory features"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Savige"
                            1 => "D&#46; Davies"
                            2 => "R&#46;J&#46; Falk"
                            3 => "J&#46;C&#46; Jennette"
                            4 => "A&#46; Wiik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1523-1755.2000.057003846.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Kidney Int"
                        "fecha" => "2000"
                        "volumen" => "57"
                        "paginaInicial" => "846"
                        "paginaFinal" => "862"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10720938"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antineutrophil cytoplasm antibody&#58; positivity and clinical correlation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Martinez Tellez"
                            1 => "B&#46; Torres Rives"
                            2 => "S&#46; Rangel Velazquez"
                            3 => "V&#46; Sanchez Rodriguez"
                            4 => "M&#46;A&#46; Ramos Rios"
                            5 => "L&#46;E&#46; Fuentes Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.reuma.2014.02.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2015"
                        "volumen" => "11"
                        "paginaInicial" => "17"
                        "paginaFinal" => "21"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24913965"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anti-neutrophil cytoplasmic autoantibodies&#58; methodological aspects and clinical significance in systemic vasculitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Radice"
                            1 => "L&#46; Bianchi"
                            2 => "R&#46;A&#46; Sinico"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.autrev.2012.08.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Autoimmun Rev"
                        "fecha" => "2013"
                        "volumen" => "12"
                        "paginaInicial" => "487"
                        "paginaFinal" => "495"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22921790"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Test characteristics of immunofluorescence and ELISA tests in 856 consecutive patients with possible ANCA-associated conditions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;H&#46; Stone"
                            1 => "M&#46; Talor"
                            2 => "J&#46; Stebbing"
                            3 => "M&#46;L&#46; Uhlfelder"
                            4 => "N&#46;R&#46; Rose"
                            5 => "K&#46;A&#46; Carson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/1529-0131(200012)13:6<424::aid-art14>3.0.co;2-q"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Care Res"
                        "fecha" => "2000"
                        "volumen" => "13"
                        "paginaInicial" => "424"
                        "paginaFinal" => "434"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14635320"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development and standardization of solid phase assays for the detection of anti-neutrophil cytoplasmic antibodies &#40;ANCA&#41;&#46; A report on the second phase of an international cooperative study on the standardization of ANCA assays"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;C&#46; Hagen"
                            1 => "K&#46; Andrassy"
                            2 => "E&#46; Csernok"
                            3 => "M&#46;R&#46; Daha"
                            4 => "G&#46; Gaskin"
                            5 => "W&#46;L&#46; Gross"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0022-1759(96)00111-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Immunol Methods"
                        "fecha" => "1996"
                        "volumen" => "196"
                        "paginaInicial" => "1"
                        "paginaFinal" => "15"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8841439"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Next-generation autoantibody testing by combination of screening and confirmation &#8211; the CytoBead&#40;R&#41; Technology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Sowa"
                            1 => "R&#46; Hiemann"
                            2 => "P&#46; Schierack"
                            3 => "D&#46; Reinhold"
                            4 => "K&#46; Conrad"
                            5 => "D&#46; Roggenbuck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12016-016-8574-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Rev Allergy Immunol"
                        "fecha" => "2017"
                        "volumen" => "53"
                        "paginaInicial" => "87"
                        "paginaFinal" => "104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27368807"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The CytoBead assay &#8211; a novel approach of multiparametric autoantibody analysis in the diagnostics of systemic autoimmune diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Sowa"
                            1 => "K&#46; Gro&#223;mann"
                            2 => "J&#46; Scholz"
                            3 => "N&#46; R&#246;ber"
                            4 => "S&#46; R&#246;diger"
                            5 => "P&#46; Schierack"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1515/labmed-2015-0036"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Lab Med"
                        "fecha" => "2015"
                        "volumen" => "38"
                        "paginaInicial" => "309"
                        "paginaFinal" => "317"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Controversies in ANCA testing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "U&#46; Specks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3949/ccjm.79.s3.02"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cleve Clin J Med"
                        "fecha" => "2012"
                        "volumen" => "79"
                        "numero" => "Suppl&#46; 3"
                        "paginaInicial" => "S7"
                        "paginaFinal" => "S11"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "International Consensus Statement on Testing and Reporting of Antineutrophil Cytoplasmic Antibodies &#40;ANCA&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Savige"
                            1 => "D&#46; Gillis"
                            2 => "E&#46; Benson"
                            3 => "D&#46; Davies"
                            4 => "V&#46; Esnault"
                            5 => "R&#46;J&#46; Falk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ajcp/111.4.507"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Clin Pathol"
                        "fecha" => "1999"
                        "volumen" => "111"
                        "paginaInicial" => "507"
                        "paginaFinal" => "513"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Simultaneous automated screening and confirmatory testing for vasculitis-specific ANCA"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Sowa"
                            1 => "K&#46; Grossmann"
                            2 => "I&#46; Knutter"
                            3 => "R&#46; Hiemann"
                            4 => "N&#46; Rober"
                            5 => "U&#46; Anderer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0107743"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLOS ONE"
                        "fecha" => "2014"
                        "volumen" => "9"
                        "paginaInicial" => "e107743"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25225805"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "El lado renal de la poliange&#237;tis microsc&#243;pica&#46; A prop&#243;sito de dos nuevos casos en Colombia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;E&#46; Andrade"
                            1 => "J&#46;d&#46;J&#46; Cantillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta M&#233;dica Colomb"
                        "fecha" => "2008"
                        "volumen" => "33"
                        "paginaInicial" => "84"
                        "paginaFinal" => "89"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antineutrophil cytoplasmic antibody-associated vasculitides&#58; is it time to split up the group&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Millet"
                            1 => "M&#46; Pederzoli-Ribeil"
                            2 => "L&#46; Guillevin"
                            3 => "V&#46; Witko-Sarsat"
                            4 => "L&#46; Mouthon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2013-203255"
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2013"
                        "volumen" => "72"
                        "paginaInicial" => "1273"
                        "paginaFinal" => "1279"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of the epidemiology of anti-neutrophil cytoplasmic antibody-associated vasculitis between Japan and the U&#46;K"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Fujimoto"
                            1 => "R&#46;A&#46; Watts"
                            2 => "S&#46; Kobayashi"
                            3 => "K&#46; Suzuki"
                            4 => "D&#46;R&#46; Jayne"
                            5 => "D&#46;G&#46; Scott"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/ker205"
                      "Revista" => array:5 [
                        "tituloSerie" => "Rheumatology &#40;Oxford&#41;"
                        "fecha" => "2011"
                        "volumen" => "50"
                        "paginaInicial" => "1916"
                        "paginaFinal" => "1920"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "DRB1&#42;15 allele is a risk factor for PR3-ANCA disease in African Americans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Cao"
                            1 => "J&#46;L&#46; Schmitz"
                            2 => "J&#46; Yang"
                            3 => "S&#46;L&#46; Hogan"
                            4 => "D&#46; Bunch"
                            5 => "Y&#46; Hu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1681/ASN.2010101058"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Nephrol"
                        "fecha" => "2011"
                        "volumen" => "22"
                        "paginaInicial" => "1161"
                        "paginaFinal" => "1167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21617122"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of primary vasculitis in Colombia and its relation with reported for Latin America"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Ochoa"
                            1 => "F&#46; Ram&#237;rez"
                            2 => "G&#46; Quintana"
                            3 => "C&#46; Toro"
                            4 => "C&#46; Ca&#241;as"
                            5 => "L&#46;F&#46; Osio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0121-8123(09)70103-3"
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Colomb Reumatol"
                        "fecha" => "2009"
                        "volumen" => "16"
                        "paginaInicial" => "248"
                        "paginaFinal" => "263"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serum anti-lysosomal-associated membrane protein-2 antibody levels in cutaneous polyarteritis nodosa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46; Kawakami"
                            1 => "A&#46; Ishizu"
                            2 => "Y&#46; Arimura"
                            3 => "Y&#46; Soma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2340/00015555-1418"
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Derm Venereol"
                        "fecha" => "2013"
                        "volumen" => "93"
                        "paginaInicial" => "70"
                        "paginaFinal" => "73"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Novel clinical and diagnostic aspects of antineutrophil cytoplasmic antibodies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Schulte-Pelkum"
                            1 => "A&#46; Radice"
                            2 => "G&#46;L&#46; Norman"
                            3 => "M&#46; Lomicronpez Hoyos"
                            4 => "G&#46; Lakos"
                            5 => "C&#46; Buchner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1155/2014/185416"
                      "Revista" => array:3 [
                        "tituloSerie" => "J Immunol Res"
                        "fecha" => "2014"
                        "paginaInicial" => "185416"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Second generation analysis of antinuclear antibody &#40;ANA&#41; by combination of screening and confirmatory testing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Scholz"
                            1 => "K&#46; Grossmann"
                            2 => "I&#46; Knutter"
                            3 => "R&#46; Hiemann"
                            4 => "M&#46; Sowa"
                            5 => "N&#46; Rober"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1515/cclm-2015-0083"
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Chem Lab Med"
                        "fecha" => "2015"
                        "volumen" => "53"
                        "paginaInicial" => "1991"
                        "paginaFinal" => "2002"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Laboratorio en reumatologia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E&#46; Wainstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0716-8640(12)70327-9"
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Med Clin Condes"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "371"
                        "paginaFinal" => "376"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antineutrophil cytoplasmic antibodies testing in a large cohort of unselected Greek patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Tsiveriotis"
                            1 => "A&#46; Tsirogianni"
                            2 => "E&#46; Pipi"
                            3 => "K&#46; Soufleros"
                            4 => "C&#46; Papasteriades"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4061/2011/626495"
                      "Revista" => array:5 [
                        "tituloSerie" => "Autoimmune Dis"
                        "fecha" => "2011"
                        "volumen" => "2011"
                        "paginaInicial" => "626495"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21687647"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Occurrence of antineutrophil cytoplasmic antibodies and associated vasculitis in patients with hyperthyroidism treated with antithyroid drugs&#58; a long-term followup study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;C&#46; Slot"
                            1 => "T&#46;P&#46; Links"
                            2 => "C&#46;A&#46; Stegeman"
                            3 => "J&#46;W&#46; Tervaert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.20927"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2005"
                        "volumen" => "53"
                        "paginaInicial" => "108"
                        "paginaFinal" => "113"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15696557"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antineutrophil cytoplasmic antibodies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;S&#46; Hoffman"
                            1 => "U&#46; Specks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/1529-0131(199809)41:9<1521::AID-ART2>3.0.CO;2-A"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "1998"
                        "volumen" => "41"
                        "paginaInicial" => "1521"
                        "paginaFinal" => "1537"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9751084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Microscopic polyangiitis&#58; clinical and laboratory findings in eighty-five patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Guillevin"
                            1 => "B&#46; Durand-Gasselin"
                            2 => "R&#46; Cevallos"
                            3 => "M&#46; Gayraud"
                            4 => "F&#46; Lhote"
                            5 => "P&#46; Callard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/1529-0131(199904)42:3<421::AID-ANR5>3.0.CO;2-6"
                      "Revista" => array:5 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "1999"
                        "volumen" => "42"
                        "paginaInicial" => "421"
                        "paginaFinal" => "430"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Renal involvement in Churg-Strauss syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;A&#46; Sinico"
                            1 => "L&#46; di Toma"
                            2 => "U&#46; Maggiore"
                            3 => "C&#46; Tosoni"
                            4 => "P&#46; Bottero"
                            5 => "E&#46; Sabadini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.ajkd.2006.01.026"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Kidney Dis"
                        "fecha" => "2006"
                        "volumen" => "47"
                        "paginaInicial" => "770"
                        "paginaFinal" => "779"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16632015"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular mimicry in pauci-immune focal necrotizing glomerulonephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Kain"
                            1 => "M&#46; Exner"
                            2 => "R&#46; Brandes"
                            3 => "R&#46; Ziebermayr"
                            4 => "D&#46; Cunningham"
                            5 => "C&#46;A&#46; Alderson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/nm.1874"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nat Med"
                        "fecha" => "2008"
                        "volumen" => "14"
                        "paginaInicial" => "1088"
                        "paginaFinal" => "1096"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of anti-GBM antibodies in sera with or without ANCA"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Hellmark"
                            1 => "J&#46;L&#46; Niles"
                            2 => "A&#46;B&#46; Collins"
                            3 => "R&#46;T&#46; McCluskey"
                            4 => "C&#46; Brunmark"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Soc Nephrol"
                        "fecha" => "1997"
                        "volumen" => "8"
                        "paginaInicial" => "376"
                        "paginaFinal" => "385"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical features and outcome of patients with both ANCA and anti-GBM antibodies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;B&#46; Levy"
                            1 => "T&#46; Hammad"
                            2 => "A&#46; Coulthart"
                            3 => "T&#46; Dougan"
                            4 => "C&#46;D&#46; Pusey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1523-1755.2004.00917.x"
                      "Revista" => array:5 [
                        "tituloSerie" => "Kidney Int"
                        "fecha" => "2004"
                        "volumen" => "66"
                        "paginaInicial" => "1535"
                        "paginaFinal" => "1540"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Antineutrophil cytoplasmic antibodies &#40;ANCA&#41; in Chinese patients with anti-GBM crescentic glomerulonephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Yang"
                            1 => "Z&#46; Tang"
                            2 => "Y&#46; Chen"
                            3 => "C&#46; Zeng"
                            4 => "H&#46; Chen"
                            5 => "Z&#46; Liu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5414/CNP6342"
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Nephrol"
                        "fecha" => "2005"
                        "volumen" => "63"
                        "paginaInicial" => "423"
                        "paginaFinal" => "428"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anti-neutrophil cytoplasmic autoantibodies with specificity for myeloperoxidase in patients with systemic vasculitis and idiopathic necrotizing and crescentic glomerulonephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;J&#46; Falk"
                            1 => "J&#46;C&#46; Jennette"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM198806233182504"
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1988"
                        "volumen" => "318"
                        "paginaInicial" => "1651"
                        "paginaFinal" => "1657"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of capture ELISA for detection of antineutrophil cytoplasmic antibodies directed against proteinase 3 in Wegener&#39;s granulomatosis&#58; first results from a multicentre study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Csernok"
                            1 => "J&#46; Holle"
                            2 => "B&#46; Hellmich"
                            3 => "J&#46; Willem"
                            4 => "C&#46; Tervaert"
                            5 => "C&#46;G&#46; Kallenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/keh028"
                      "Revista" => array:5 [
                        "tituloSerie" => "Rheumatology &#40;Oxford&#41;"
                        "fecha" => "2004"
                        "volumen" => "43"
                        "paginaInicial" => "174"
                        "paginaFinal" => "180"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The diagnostic value of anti-neutrophil cytoplasmic antibody testing in a routine clinical setting"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;S&#46; McLaren"
                            1 => "R&#46;H&#46; Stimson"
                            2 => "E&#46;R&#46; McRorie"
                            3 => "J&#46;E&#46; Coia"
                            4 => "R&#46;A&#46; Luqmani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/qjmed/94.11.615"
                      "Revista" => array:6 [
                        "tituloSerie" => "QJM"
                        "fecha" => "2001"
                        "volumen" => "94"
                        "paginaInicial" => "615"
                        "paginaFinal" => "621"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11704691"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Position paper&#58; Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "X&#46; Bossuyt"
                            1 => "J&#46;W&#46; Cohen Tervaert"
                            2 => "Y&#46; Arimura"
                            3 => "D&#46; Blockmans"
                            4 => "L&#46;F&#46; Flores-Su&#225;rez"
                            5 => "L&#46; Guillevin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/nrrheum.2017.140"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nat Rev Rheumatol"
                        "fecha" => "2017"
                        "volumen" => "13"
                        "paginaInicial" => "683"
                        "paginaFinal" => "692"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection of antineutrophil cytoplasmic antibodies &#40;ANCAs&#41;&#58; a multicentre European Vasculitis Study Group &#40;EUVAS&#41; evaluation of the value of indirect immunofluorescence &#40;IIF&#41; versus antigen-specific immunoassays"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Damoiseaux"
                            1 => "E&#46; Csernok"
                            2 => "N&#46; Rasmussen"
                            3 => "F&#46; Moosig"
                            4 => "P&#46; van Paassen"
                            5 => "B&#46; Baslund"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2016-209507"
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2017"
                        "volumen" => "76"
                        "paginaInicial" => "647"
                        "paginaFinal" => "653"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack495488"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0210" class="elsevierStylePara elsevierViewall">This study was supported by the <span class="elsevierStyleGrantSponsor" id="gs0005"><span class="elsevierStyleItalic">Hospital Militar Central</span> and <span class="elsevierStyleItalic">Instituto de Referencia Andino</span></span> &#40;<span class="elsevierStyleGrantNumber" refid="gs0005">HMC 2014-080</span>&#41;&#44; supported by <span class="elsevierStyleGrantSponsor" id="gs0010">Biolore Ltda and Qu&#237;mica Internacional Ltda</span>&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">We would like to thank Sara Pineda-Barrag&#225;n S&#46; and Laura M&#46; Rey for the technical execution of the autoantibodies and Adela Castro-Guti&#233;rrez for her contribution in the collection of the data&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735743/0000001600000006/v1_202011251719/S2173574319301790/v1_202011251719/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "43294"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001600000006/v1_202011251719/S2173574319301790/v1_202011251719/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574319301790?idApp=UINPBA00004M"
]