Antibodies Directed Against Neutrophils (C-ANCA and P-ANCA) are of Distinct Diagnostic Value in Systemic Vasculitis

Venning, Michael; Quinn, Anthony G.; Broomhead, V; Bird, A. G.

doi:10.1093/qjmed/77.3.1287

Cited by 49 publications

(20 citation statements)

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“…In Cau casians, PR3 accounts for 85-90% of cANCA antigen, and many are presenting with WG [7,9], pANCA is much more common in our patients. There were 72% of our pANCA patients having positive anti-MPO antibodies and this is very similar to the 90% found in Caucasians [4,7], However, a wide spectrum of dis eases was found in Chinese patients who were pANCA positive and had MPA (table 5). SLE and MPA represent the two disease groups with the most patients having pANCA.…”

Section: Discussionmentioning

confidence: 79%

“…SLE and MPA represent the two disease groups with the most patients having pANCA. MPO is the most important antigen for pANCA and accounts for 90% of ANCA cases [4,7], Anti-MPO antibodies were associated initially with systemic vasculi tis and idiopathic necrotizing and crescentic GN. Later, it was found to be present in microscopic and classical PAN, Churg-Strauss syndrome, polyangiitis overlap syndrome, and WG [23].…”

Section: Discussionmentioning

confidence: 99%

“…By indirect immunofluorescence (IIF), two types of ANCA patterns were seen on ethanol-fixed neutrophils: the cytoplasmic (cANCA) and the perinuclear (pANCA) [5], Basically, cANCA is commonly found in patients with active WG and pANCA in patients with MPA or idio pathic necrotizing and crescentic GN [6,7], However, there is overlap between the two different patterns in diagnosing various types of vasculitides [8], Two major ANCA antigens had been identified: proteinase 3 (PR3), a serine protease of 29 kD which accounts for 85-90% of the cANCA antigen [7,9], and myeloperoxidase (MPO), another myeloid lysosomal enzyme producing an artefactual perinuclear staining of ethanol-fixed neutrophils in 90% of pANCA [4,7]. Apparently ANCA IIF combined with enzyme-linked immunosorbent assay using purified proteins as substrate like MPO and PR3 showed a very high sensitivity and specificity in diagnosing vasculitides [ 10].…”

Section: Introductionmentioning

confidence: 99%

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Use of Antineutrophil Cytoplasmic Autoantibodies in Diagnosing Vasculitis in a Chinese Patient Population

Li¹,

Leung²,

Lai³

et al. 1994

Am J Nephrol

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Antineutrophil cytoplasmic autoantibodies (ANCA) have been used as markers of systemic vasculitides, including microscopic polyarteritis (MPA) and Wegener’s granulomatosis. The diagnostic potential of ANCA assays together with antibodies against the neutrophil enzymes myeloperoxidase (MPO) and proteinase 3 for detecting a systemic vasculitis was tested in a Chinese patient population. 672 sera were received for ANCA assay, and ANCA detected by indirect immunofluorescence was positive in 73 sera from 42 patients. Of the 42 patients, 3 had cytoplasmic ANCA, while 39 had a perinuclear pattern. There was no patient with Wegener’s granulomatosis. Two cytoplasmic ANCA positive patients suffered from ulcerative colitis. Another cytoplasmic ANCA positive patient was a carrier of human immunodeficiency virus. Of the 39 perinuclear ANCA positive patients, 10 had MPA. Eight of them were tested for anti-MPO antibody, and all were positive. Other immune disorders that were perinuclear ANCA positive included: 13 patients with systemic lupus erythematosus, 3 with mixed connective tissue disease, 1 with Goodpasture’s syndrome, 2 with inflammatory bowel disease, and 2 patients with IgA nephropathy. Anti-MPO antibody was not specific for MPA, and 7 out of the 13 patients with systemic lupus erythematosus were anti-MPO antibody positive. Our study suggests that ANCA and anti-MPO antibody are not specific for MPA in a Chinese population. They would alert the clinician of the possibility of vasculitis, but a clinicopathological correlation is essential in making the diagnosis.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of Antineutrophil Cytoplasmic Autoantibodies in Diagnosing Vasculitis in a Chinese Patient Population

Li¹,

Leung²,

Lai³

et al. 1994

Am J Nephrol

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“…Still, there are some cases of the disease where ANCA is negative (57). Off all the ANCA associated with GPA, 80-95% of cases are associated with c-ANCA with autoantibodies directed against proteinase 3 antibodies (PR3) the remainder are p-ANCA directed against myeloperoxidase antibodies (MPO) (58,59).…”

Section: Diagnosismentioning

confidence: 99%

Granulomatosis with polyangiitis (Wegener's disease): An updated review of ocular disease manifestations

Kubaisi

Samra

Foster

2016

IRDR

117

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“…1 In a patient presenting with clinical findings suggestive for GPA, the confirm diagnosis is made by a tissue biopsy or sufficient positive titer of antineutrophil cytoplasmic antibody (c-ANCA) which is highly specific for GPA. 3,4 Suggested treatment for GPA consists of IV glucocorticoids and oral cyclophosphamide. 5,6 About 50-70% of patients experience relapsing episodes.…”

Section: Introductionmentioning

confidence: 99%

Concomitant presentation of myocarditis and non-bacterial thrombotic endocarditis in a patient with granulomatosis with polyangiitis

et al. 2014

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Granulomatosis with polyangiitis (GPA) is a necrotizing vasculitis. The etiology of the disease is not completely known. In this report, we describe a 47-year-old male who presented with ongoing dyspnea. He is a known case of GPA for 3 years based on skin biopsy and positive antineutrophil cytoplasmic antibody. The electrocardiogram showed changes suggestive for myocarditis. A transthoracic and trans esophageal echocardiogram revealed left ventricular systolic dysfunction, thickened left atrial and ventricular wall and vegetation on mitral valve. Blood cultures were negative. Myocarditis and nonbacterial thrombotic endocarditis (NBTE) were diagnosed. As far as we know, NBTE is a rare manifestation of GPA and its presentation with myocarditis is not reported to date. This case indicates the uncommon manifestations of GPA and notifies the importance of performing echocardiography in order to prevent life threatening cardiac complications of the disease.

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Antibodies Directed Against Neutrophils (C-ANCA and P-ANCA) are of Distinct Diagnostic Value in Systemic Vasculitis

Cited by 49 publications

References 0 publications

Use of Antineutrophil Cytoplasmic Autoantibodies in Diagnosing Vasculitis in a Chinese Patient Population

Use of Antineutrophil Cytoplasmic Autoantibodies in Diagnosing Vasculitis in a Chinese Patient Population

Granulomatosis with polyangiitis (Wegener's disease): An updated review of ocular disease manifestations

Concomitant presentation of myocarditis and non-bacterial thrombotic endocarditis in a patient with granulomatosis with polyangiitis

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