Document Detail


Detection of autoantibodies against myeloid lysosomal enzymes: a useful adjunct to classification of patients with biopsy-proven necrotizing arteritis.
MedLine Citation:
PMID:  1677531     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Assessment of the value of determination of antineutrophil cytoplasmic antibodies (ANCA) and its specificities for classification of patients with biopsy-proven necrotizing arteritis. PATIENTS AND METHODS: The serum samples of 28 consecutive patients with biopsy-proven vasculitis involving medium- and/or small-sized arteries were tested for ANCA by an indirect immunofluorescence technique, by neutrophil extract enzyme-linked immunosorbent assay (ELISA), and by catching ELISA. RESULTS: Eight patients had Churg-Strauss syndrome; six had myeloperoxidase (MPO) antibodies, and in the other two patients, ANCA were not detected. Six patients had polyarteritis nodosa (PAN) limited to the skin and the musculoskeletal system; ANCA were not detected in these patients. Two patients had systemic PAN and both had MPO antibodies. The remaining 12 patients had overlapping clinical features of the different forms of vasculitis. Five patients had polyarteritis in combination with chronic nasal inflammation and glomerulonephritis compatible with Wegener's granulomatosis (WG) but without granulomas in the respiratory tract. All five patients had 29-kd serine protease antibodies. Two patients had polyarteritis in combination with nasal polyposis and asthma compatible with Churg-Strauss syndrome, but eosinophilia was not detected. Both patients had MPO antibodies. Three patients with unclassified granulomatous arteritis had either elastase antibodies or ANCA of unknown specificity. One patient with unclassified systemic vasculitis had 29-kd serine protease antibodies, and one patient with necrotizing arteritis of the bowel in combination with Schönlein-Henoch purpura was negative for ANCA. CONCLUSION: Determination of ANCA and its specificities is a useful adjunct to the classification of patients with biopsy-proven necrotizing arteritis. Within the spectrum of idiopathic vasculitides, 29-kd serine protease antibodies are associated with WG, MPO antibodies are associated with Churg-Strauss syndrome and systemic PAN, and PAN limited to the skin and the musculoskeletal system is not associated with ANCA.
Authors:
J W Tervaert; P C Limburg; J D Elema; M G Huitema; G Horst; T H The; C G Kallenberg
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of medicine     Volume:  91     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1991 Jul 
Date Detail:
Created Date:  1991-08-23     Completed Date:  1991-08-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  59-66     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University Hospital, Groningen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antibodies, Antineutrophil Cytoplasmic
Arteries
Autoantibodies / analysis*
Biological Markers / chemistry*
Biopsy
Churg-Strauss Syndrome / immunology,  pathology
Enzyme-Linked Immunosorbent Assay
Female
Fluorescent Antibody Technique
Humans
Immunoglobulin G / analysis*
Male
Middle Aged
Neutrophils / immunology*
Polyarteritis Nodosa / immunology*,  pathology
Vasculitis / immunology,  pathology
Wegener Granulomatosis / immunology,  pathology
Chemical
Reg. No./Substance:
0/Antibodies, Antineutrophil Cytoplasmic; 0/Autoantibodies; 0/Biological Markers; 0/Immunoglobulin G

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