Clinical significance of positive anti-neutrophil cytoplasmic antibodies without evidence of anti-neutrophil cytoplasmic antibodies-associated vasculitis

被引:13
作者
Bornstein, Gil [1 ,2 ]
Ben-Zvi, Ilan [3 ,4 ,5 ]
Furie, Nadav [3 ,4 ,5 ]
Grossman, Chagai [3 ,4 ,5 ]
机构
[1] Tel Aviv Sourasky Med Ctr, Dept Internal Med B, Tel Aviv, Israel
[2] Tel Aviv Sourasky Med Ctr, Rheumatol Unit, Tel Aviv, Israel
[3] Chaim Sheba Med Ctr, Dept Internal Med F, Ramat Gan, Israel
[4] Chaim Sheba Med Ctr, Rheumatol Unit, Ramat Gan, Israel
[5] Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel
关键词
anti-neutrophil cytoplasmic antibodies; enzyme-linked immunosorbent assay; vasculitis; SYSTEMIC VASCULITIS; ANCA; AUTOANTIBODIES; DIAGNOSIS; ELISA; ENDOCARDITIS; ASSAYS;
D O I
10.1111/1756-185X.13483
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim Anti-neutrophil cytoplasmic antibodies (ANCA) have a role in the diagnostic workup of ANCA-associated vasculitis. However, the clinical significance of positive ANCA in the absence of vasculitis is yet to be determined. Therefore, we sought to investigate the clinical spectrum and rate of patients with a positive ANCA without evidence of vasculitis. Methods Retrospective analysis of patients positive for cytoplasmic ANCA (C-ANCA) and proteinase 3 (PR3) or P-ANCA and myeloperoxidase (MPO) between 2007 and 2016 in the Chaim Sheba Medical Center, Israel. The proportion of patients who had no evidence of vasculitis among all patients with a positive C-ANCA/PR3 or P-ANCA/MPO was calculated according to tertiles of enzyme-linked immunosorbent assay (ELISA) antibody levels. Results Among 113 patients who tested positive for C-ANCA/PR3 or P-ANCA/MPO, 68 (60.1%) had no evidence of vasculitis. ELISA antibody titers were significantly higher among patients with vasculitis than those without (6.2 vs 3.2, for C-ANCA/PR3 and 5.4 vs 2.6 for P-ANCA/MPO, P < 0.05). The proportion of patients without vasculitis among all patients with a positive C-ANCA/PR3 and among all patients with a positive P-ANCA/MPO declined in parallel to the increases in ELISA antibody level tertiles (96%, 57% and 22% in the 1st, 2nd and highest tertiles, respectively, for patients with C-ANCA/PR3 patients and 100%, 66% and 20% in the 1st, 2nd and highest tertiles, respectively, for patients with P-ANCA/MPO). Conclusion A significant proportion of patients with a positive C-ANCA/PR3 or P-ANCA/MPO do not have evidence of vasculitis, particularly those with low-medium ELISA antibody titers. Using a higher threshold of ANCA titers may be required to improve specificity.
引用
收藏
页码:940 / 945
页数:6
相关论文
共 50 条
  • [31] Anti-neutrophil cytoplasmic antibodies and pathogenesis of small vessel vasculitides
    Csernok, E
    AUTOIMMUNITY REVIEWS, 2003, 2 (03) : 158 - 164
  • [32] Pulmonary fibrosis associated with anti-neutrophil cytoplasmic antibody-positive vasculitis
    Fernandez Casares, Marcelo
    Gonzalez, Alejandra
    Caputo, Flavia
    Bottinelli, Yanina
    Nastavi, Patricia
    Zamboni, Marcelo
    MEDICINA-BUENOS AIRES, 2012, 72 (04) : 329 - 331
  • [33] Detection of ANCA (Anti-Neutrophil Cytoplasmic Antibodies) and related neurological diseases
    Aziz, S.
    Tahiri-Jouti, N.
    Ibn Moufti, R.
    Fellah, H.
    Oudghiri, M.
    Naya, A.
    Slassi, I.
    Zamiati, S.
    IMMUNO-ANALYSE & BIOLOGIE SPECIALISEE, 2012, 27 (05): : 254 - 259
  • [34] Animal models of anti-neutrophil cytoplasmic antibody-associated vasculitis
    Coughlan, A. M.
    Freeley, S. J.
    Robson, M. G.
    CLINICAL AND EXPERIMENTAL IMMUNOLOGY, 2012, 169 (03) : 229 - 237
  • [35] Mouse Models of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
    Gan, Poh-Yi
    Ooi, Joshua D.
    Kitching, A. Richard
    Holdsworth, Stephen R.
    CURRENT PHARMACEUTICAL DESIGN, 2015, 21 (18) : 2380 - 2390
  • [36] Clinical significance of HEp-2 cell cytoplasmic patterns in anti-neutrophil cytoplasmic antibody associated vasculitis
    Zhang, Naidan
    Ji, Chaixia
    Bao, Xiao
    Yuan, Chengliang
    MEDICINE, 2022, 101 (25)
  • [37] Neutrophil Extracellular Traps Contain Selected Antigens of Anti-Neutrophil Cytoplasmic Antibodies
    Panda, Rachita
    Krieger, Thorsten
    Hopf, Luke
    Renne, Thomas
    Haag, Friedrich
    Roeber, Nadja
    Conrad, Karsten
    Csernok, Elena
    Fuchs, Tobias A.
    FRONTIERS IN IMMUNOLOGY, 2017, 8
  • [38] Clinical and laboratory features of myelitis patients with anti-neutrophil cytoplasmic antibodies
    Nakashima, I
    Fujihara, K
    Endo, M
    Seki, H
    Okita, N
    Takase, S
    Itoyama, Y
    JOURNAL OF THE NEUROLOGICAL SCIENCES, 1998, 157 (01) : 60 - 66
  • [39] Detection of anti-neutrophil cytoplasmic antibodies under actual clinical testing conditions
    Russell, KA
    Wiegert, E
    Schroeder, DR
    Homburger, HA
    Specks, U
    CLINICAL IMMUNOLOGY, 2002, 103 (02) : 196 - 203
  • [40] An international survey on anti-neutrophil cytoplasmic antibodies (ANCA) testing in daily clinical practice
    Damoiseaux, Jan
    Heijnen, Ingmar
    Van Campenhout, Christel
    Eriksson, Catharina
    Fabien, Nicole
    Herold, Manfred
    van der Molen, Renate G.
    Egner, William
    Patel, Dina
    Plaza-Lopez, Aresio
    Radice, Antonella
    Rego de Sousa, Marie Jose
    Viander, Markku
    Shoenfeld, Yehuda
    CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 2018, 56 (10) : 1759 - 1770