Antineutrophil cytoplasm antibodies in systemic polyarteritis nodosa with and without hepatitis B virus infection and Churg-Strauss syndrome--62 patients
- PMID: 7901412
Antineutrophil cytoplasm antibodies in systemic polyarteritis nodosa with and without hepatitis B virus infection and Churg-Strauss syndrome--62 patients
Abstract
Objective: Antibodies directed against components of neutrophil cytoplasm have been detected in various systemic vasculitides and especially in Wegener's granulomatosis. In polyarteritis nodosa (PAN) and Churg-Strauss syndrome, few data are available and correlation between clinical manifestations and antineutrophil cytoplasm antibodies (ANCA) has not been established. Therefore, we tested, before treatment of vasculitis, 62 consecutive patients suffering from PAN with hepatitis B virus (HBV) markers, PAN of unknown etiology or Churg-Strauss syndrome.
Methods: Only patients with PAN and Churg-Strauss syndrome were included in the study. The diseases were histologically and/or angiographically proven. Every patient's serum was tested by an indirect immunofluorescence assay (IFA) and, in 37 cases, by an enzyme linked immunosorbent assay (ELISA).
Results: ANCA detected by IFA were observed in 10.7% of the patients with PAN with HBV markers, in 27.3% of the patients with PAN without HBV markers and in 66.7% of the patients with Churg-Strauss syndrome. When ELISA was performed, 11.1% of the patients with PAN associated with HBV infection, 20% of the patients with PAN without HBV markers and 55.6% of the patients with Churg-Strauss syndrome were positive. ANCA were positively correlated with asthma and purpura and negatively correlated with HBV markers.
Conclusion: Regardless of the technique used, Churg-Strauss syndrome was associated with ANCA in about 60% of the cases while, in PAN of unknown etiology, ANCA were found in about 25% of cases. In contrast, IFA and ELISA only detected ANCA in a limited number of cases of PAN related to HBV infection. ELISA positivity in patients with PAN and Churg-Strauss syndrome was usually associated with antimyeloperoxidase antibodies. In our cases of PAN, ANCA and purpura were significantly correlated, suggesting that, in these cases, small vessels are involved and therefore macroscopic and microscopic PAN coexist. Thus it seems that ANCA are essentially present in the cases of small vessel vasculitis, as has been described, and are not a marker of pure macroscopic PAN, at least at our present level of understanding of these antibodies.
Comment in
-
Antineutrophil cytoplasmic antibodies in systemic polyarteritis nodosa with and without hepatitis B virus infection and Churg-Strauss syndrome--62 patients.J Rheumatol. 1994 Jun;21(6):1173-4. J Rheumatol. 1994. PMID: 7932443 No abstract available.
Similar articles
-
Prevalence and clinical significance of antineutrophil cytoplasmic antibodies in Churg-Strauss syndrome.Arthritis Rheum. 2005 Sep;52(9):2926-35. doi: 10.1002/art.21250. Arthritis Rheum. 2005. PMID: 16142760
-
Detection of autoantibodies against myeloid lysosomal enzymes: a useful adjunct to classification of patients with biopsy-proven necrotizing arteritis.Am J Med. 1991 Jul;91(1):59-66. doi: 10.1016/0002-9343(91)90074-8. Am J Med. 1991. PMID: 1677531
-
Analysis of autoantibody repertoires in small- and medium-sized vessels vasculitides. Evidence for specific perturbations in polyarteritis nodosa, microscopic polyangiitis, Churg-Strauss syndrome and Wegener's granulomatosis.J Autoimmun. 2005 Mar;24(2):169-79. doi: 10.1016/j.jaut.2004.11.001. J Autoimmun. 2005. PMID: 15829409
-
[ANCA-associated vasculitis (Wegener's granulomatosis, Churg-Strauss syndrome, microscopic polyangiitis). 1. Systemic aspects, pathogenesis and clinical aspects].Z Rheumatol. 1995 Sep-Oct;54(5):279-90. Z Rheumatol. 1995. PMID: 8578884 Review. German.
-
[Review article: Antineutrophil cytoplasmic antibody in small vessel vasculitis].Rinsho Byori. 2010 May;58(5):480-9. Rinsho Byori. 2010. PMID: 20560457 Review. Japanese.
Cited by
-
Clinical and pathological classification of ANCA-associated vasculitis: what are the controversies?Clin Exp Immunol. 1995 Jul;101 Suppl 1(Suppl 1):18-22. doi: 10.1111/j.1365-2249.1995.tb06156.x. Clin Exp Immunol. 1995. PMID: 7606854 Free PMC article. Review. No abstract available.
-
Hepatitis B virus infection associated with polyarteritis nodosa and microscopic polyangiitis.BMJ Case Rep. 2021 May 19;14(5):e240015. doi: 10.1136/bcr-2020-240015. BMJ Case Rep. 2021. PMID: 34011661 Free PMC article.
-
Clinical value of antineutrophil cytoplasmic antibodies.Curr Rheumatol Rep. 2000 Oct;2(5):383-9. doi: 10.1007/s11926-000-0037-3. Curr Rheumatol Rep. 2000. PMID: 11123087 Review.
-
Classification and management of necrotising vasculitides.Drugs. 1997 May;53(5):805-16. doi: 10.2165/00003495-199753050-00006. Drugs. 1997. PMID: 9129867 Review.
-
Pulmonary vasculitis: classification, clinical features, and management.Clin Rev Allergy Immunol. 1997 Spring;15(1):73-95. doi: 10.1007/BF02828279. Clin Rev Allergy Immunol. 1997. PMID: 9209803 Review. No abstract available.
MeSH terms
Substances
LinkOut - more resources
Medical