| Title | Prevalence of antineutrophil cytoplasmic antibodies in patients with various pulmonary diseases or multiorgan dysfunction. | | Author(s) | Vassilopoulos D, Niles JL, Villa-Forte A, Arroliga AC, Sullivan EJ, Merkel PA, Hoffman GS | | Institution | The Henry Dunant Hospital, Athens, Greece. | | Source | Arthritis Rheum 2003 Apr 15; 49(2):151-5. | | MeSH | Antibodies, Antineutrophil Cytoplasmic
Antibody Specificity
Enzyme-Linked Immunosorbent Assay
False Positive Reactions
Fluorescent Antibody Technique, Indirect
Humans
Inpatients
Intensive Care
Lung Diseases
Multiple Organ Failure
Outpatients
Prospective Studies
Seroepidemiologic Studies
Wegener's Granulomatosis
| | Abstract | OBJECTIVE: To determine the prevalence of antineutrophil cytoplasmic antibodies (ANCA) in patients with diseases that may mimic systemic vasculitides, such as severe multiorgan dysfunction (MOD) and parenchymal pulmonary disorders.
METHODS: We conducted a prospective study of patients with MOD admitted to the medical intensive care unit and patients with various lung diseases seen at the outpatient pulmonary clinic of a tertiary care hospital. Patients with a documented diagnosis of Wegener's granulomatosis (WG) served as positive controls. ANCA were determined in serum samples from each patient by a combination of indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assays (ELISAs) for antibodies to proteinase-3 and myeloperoxidase (anti-MPO).
RESULTS: Ninety-nine patients with MOD, 29 outpatients with various lung disorders, and 18 patients with WG were included in the study. ANCA were detected by IIF alone in 16% (15/96) of patients with nonvasculitic MOD and 17% (5/29) of outpatients with various pulmonary disorders. The majority of the positive IIF specimens from each group displayed an atypical IIF pattern (73% and 80%, respectively). Only 1 specimen from patients with nonvasculitic disorders was positive for anti-MPO. ANCA by both IIF and ELISA were detected in 78% (12/14) of control patients with WG.
CONCLUSION: Detection of ANCA by the combination of IIF and antigen-specific assays for proteinase 3 and myeloperoxidase in diseases that mimic systemic vasculitides is highly specific for WG, microscopic polyangiitis, and Churg-Strauss syndrome. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
| | PubMed ID | 12687504 |
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