Occupational exposure in ANCA-positive patients:: A case-control study

被引:49
作者
Beaudreuil, S
Lasfargues, G
Lauériere, L
El Ghoul, Z
Fourquet, F
Longuet, C
Halimi, JM
Nivet, H
Büchler, M
机构
[1] CHU Bretonneau, Dept Nephrol & Clin Immunol, F-37044 Tours, France
[2] CHU Bretonneau, INSERM, EMIU 0010, F-37044 Tours, France
[3] CHU Bretonneau, Immunol Lab, F-37044 Tours, France
[4] CHU Bretonneau, Dept Publ Hlth, F-37044 Tours, France
关键词
antineutrophil cytoplasmic antibodies; occupational exposure; silica; case-control study;
D O I
10.1111/j.1523-1755.2005.00295.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background. Antineutrophil cytoplasmic autoantibodies (ANCA) are valuable biomarkers for the diagnosis and follow-up of small vessel vasculitis. The role of ANCA has not yet been fully established, but genetic, infectious, and/or environmental factors may increase susceptibility to these diseases. We performed an epidemiologic study to investigate whether the presence of ANCA was associated with silica or any other form of occupational exposure, regardless of the underlying disease. Methods. All consecutive ANCA-positive patients recorded at the institution's Laboratory of Immunology between 1990 and 2000 were included. Patients hospitalized in a unit of internal medicine matched for age and gender were selected as controls (two controls/case). Qualitative and semiquantitative professional exposure and smoking habits were analyzed by five experts blind to the diagnosis. Results. Univariate analysis showed that patients who reported dust exposure had a 2.6 greater risk of being ANCA-positive (P = 0.007) (odds ratio 2.6; 95% CI 1.3 to 5.3) and individuals with professional exposure to silica had a 3.4 higher risk of being ANCA-positive (P = 0.03) (odds ratio 3.4; 95% CI 1.1 to 9.9). None of the other environmental factors or smoking habits were different between ANCA-positive patients and controls. There was no difference in silica exposure between patients with cytoplasmic ANCA (c-ANCA), perinuclear ANCA (p-ANCA), or atypical ANCA. Semiquantitative analysis showed a dose effect of silica exposure with a nearly sevenfold greater risk of being ANCA-positive compared to controls (P = 0.02) (odds ratio 6.9; 95% CI 1.3 to 35.1). Conclusion. These results support the hypothesis that the presence of ANCA in plasma might at least partially be related to occupational exposure.
引用
收藏
页码:1961 / 1966
页数:6
相关论文
共 34 条
[1]  
Aikoh T, 1998, INT J ONCOL, V12, P1355
[2]   TESTS FOR LINEAR TRENDS IN PROPORTIONS AND FREQUENCIES [J].
ARMITAGE, P .
BIOMETRICS, 1955, 11 (03) :375-386
[3]  
DION E, 2002, OCCUP ENVIRON MED, V59, P545
[4]  
Duna GE, 1998, CLIN EXP RHEUMATOL, V16, P669
[6]   ALPHA1-ANTITRYPSIN GENETIC-POLYMORPHISM IN ANCA-POSITIVE SYSTEMIC VASCULITIS [J].
ESNAULT, VLM ;
TESTA, A ;
AUDRAIN, M ;
ROGE, C ;
HAMIDOU, M ;
BARRIER, JH ;
SESBOUE, R ;
MARTIN, JP ;
LESAVRE, P .
KIDNEY INTERNATIONAL, 1993, 43 (06) :1329-1332
[7]   Diffuse endothelial dysfunction is common to ANCA associated systemic vasculitis and polyarteritis nodosa [J].
Filer, AD ;
Gardner-Medwin, JM ;
Thambyrajah, J ;
Raza, K ;
Carruthers, DM ;
Stevens, RJ ;
Liu, L ;
Lowe, SE ;
Townend, JN ;
Bacon, PA .
ANNALS OF THE RHEUMATIC DISEASES, 2003, 62 (02) :162-167
[8]  
Font J, 1998, BRIT J RHEUMATOL, V37, P1287
[9]  
GREGORINI G, 1993, ADV EXP MED BIOL, V336, P435
[10]  
HALBWACHSMECARELLI L, 1992, CLIN EXP IMMUNOL, V90, P79