Document Detail


Occupational exposure in ANCA-positive patients: a case-control study.
MedLine Citation:
PMID:  15840044     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Séverine Beaudreuil; Gérard Lasfargues; Laurence Lauériere; Zen El Ghoul; Florence Fourquet; Cédric Longuet; Jean-Michel Halimi; Hubert Nivet; Matthias Büchler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kidney international     Volume:  67     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-20     Completed Date:  2005-08-22     Revised Date:  2006-08-17    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1961-6     Citation Subset:  IM    
Affiliation:
Department of Nephrology and Clinical Immmunology, CHU Bretonneau, Tours, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antibodies, Antineutrophil Cytoplasmic / blood*
Biological Markers / blood
Case-Control Studies
Dose-Response Relationship, Drug
Dust
Female
Humans
Male
Middle Aged
Occupational Diseases / etiology
Occupational Exposure*
Risk Factors
Silicon Dioxide / administration & dosage,  adverse effects
Vasculitis / etiology
Chemical
Reg. No./Substance:
0/Antibodies, Antineutrophil Cytoplasmic; 0/Biological Markers; 0/Dust; 7631-86-9/Silicon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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