Summary
Clinical and histological data leading to precise diagnosis were retrospectively obtained in 98 patients with antineutrophil cytoplasmic antibodies (ANCA) detected by indirect immunofluorescence (IIF). Specificity was determined by myeloperoxydase (MPO) and proteinase 3 (PR3) specific ELISA in all and a comparative study based on ANCA specificity was performed. Vasculitis was present in all cases. PR3-ANCA occurred predominantly in males (25138) with WG (19138). MPO-ANCA occurred predominantly in older women and were often associated with various autoimmune disorders. There was a high prevalence of lung hemorrhage (18145) and mPA (26145) in this group. Patients with negative MPO and PR3 specific ELISA despite positive IIF (n = 15) were almost exclusively WG (13/15) and were characterized by a high prevalence of hepatic and digestive manifestations. Renal and patient survival at the 75th percentile was 15 months with MPO-ANCA and 16 months with PR3, and was similar for patients with WG and mPA. With immunosuppressive treatment, ANCA disappeared in 66% of cases and this disappearance was always associated with absence of disease activity.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Andrassy K., Erb A., Koderisch J., Waldherr R., Ritz E. Wegener’s granulomatosis with renal involvement: patient survival and correlations between initial renal function, renal histology, therapy and renal outcome. Clin. Nephrol. 1991, 35, 139–147.
Cameron J.S. New horizons in renal vasculitis. Klin. Wochenschr. 1991, 13, 1–16.
Cohen Tervaert J.W., Woude F.J., Fauci A.S., Ambrus J.L., Velosa J., Keane W.F., Meijer S., Van der Giessen M., The T.H., Hem G.K., Kallenberg C.G.M. Association between active Wegener’s Granulomatosis and anticytoplasmic antibodies. Arch. Int. Med. 1989, 149, 2461–65.
Cohen Tervaert J.W., Huitema M.G., Hené R., Sluiter W.J., The T.H., Van der Hem G.K., Kallenberg C.G.M. Prevention of relapses in Wegener’s granulomatosis by treatment based on antineutrophil cytoplasmic antibody titres. Lancet, 1990, 336, 709–711.
Falk R.J., Hogan S., Carey T., Jennette C. Clinical course of anti-neutrophil cytoplasmic autoantibody-associated glomerulonephritis and systemic vasculitis. Ann. Int. Med., 1990, 113, 656–663.
Jennette J.C., Falk R.J. Antineutrophil cytoplasmic autoantibodies and associated Diseases: a review. Am. J. Kidney Dis., 1990, 15, 517–529.
Lesavre P., Noël L.H., Chauveau D., Geffriaud C., Grünfeld J.P. Antigen specificities and clinical distribution of ANCA in kidney disease. Kiln. Wochenschr. 1991, 69, 552–557.
Roberts D.E., Peebles C.L., Curd J.G., Tan E.M., Rubin R.L. Autoantibodies to native myeloperoxydase in patients presenting with pulmonary hemorrhage and acute renal failure. Am. J. Kidney Dis 1991, 18, 197–198.
Savage C.O.S., Winearls C.G., Evans J., Rees A.J., Lockwood C.M. Microscopic polyarteritis: Presentation, pathology and prognosis. Q. J. Med. 1985, 56, 467–483.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1993 Springer Science+Business Media New York
About this chapter
Cite this chapter
Geffriaud-Ricouard, C., Noël, L.H., Chauveau, D., Houhou, S., Grünfeld, J.P., Lesavre, P. (1993). Clinical Significance of ANCA in 98 Patients. In: Gross, W.L. (eds) ANCA-Associated Vasculitides. Advances in Experimental Medicine and Biology, vol 336. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-9182-2_41
Download citation
DOI: https://doi.org/10.1007/978-1-4757-9182-2_41
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4757-9184-6
Online ISBN: 978-1-4757-9182-2
eBook Packages: Springer Book Archive