A Case of Goodpasture's Syndrome Associated with Anti-Myeloperoxidase Antibodies.

Abstract

A case of Goodpasture's syndrome with anti-myeloperoxidase (MPO) antibodies is reported. Histological examination revealed crescentic glomerulonephritis and alveolar hemorrhage with linear deposition of IgG along the glomerular capillary walls and alveolar capillary walls by immunofluorescence microscopy. Not only anti-glomerular basement membrane (GBM) antibodies but also anti-MPO antibodies, an anti-neutrophil cytoplasmic antibody, were simul taneously detected in the serum. Although it is generally accepted that crescentic glomerulo nephritis in Goodpasture's syndrome is mediated by anti-GBM antibodies, this case suggested that anti-MPO antibodies might also participate in the pathogenesis of crescentic glomerulo nephritis and probably alveolar hemorrhage of Goodpasture's syndrome, especially with vasculitis.

Myeloperoxidase Fragments Reacting with Serum from a Patient with Myeloperoxidase-Anti-Neutrophil Cytoplasmic Antibody-Positive Glomerulonephritis

“…In some patients with glomerulonephritis of the pauci-immune type with crescent disease, an anti-MPO antibody can be detected. The titer of anti-MPO antibody correlates well with the active phase ofglomerulonephritis, 9 and we have also demonstrated a good correlation between the extent of crescent formation and the MPO antibody titer. 10 An immune complex of MPO with its antibody, which may stimulate the release of MPO halide and superoxide anions produced from the neutrophils at the basement membrane of glomeruli, may be considered a risk factor in glomerulonephritis.…”

Dual myeloperoxidase-antineutrophil cytoplasmic antibody- and antiglomerular basement membrane antibody-positive cases associated with prior pulmonary fibrosis: a report of four cases

“…Goodpasture syndrome (RPGN and pulmonary hemorrhage) typically affects male smokers or males with lung exposure to chemical agents, while MPO-ANCA-associated vasculitis tends to occur in elderly individuals [9,10]. Over the last 15 years, dual positive cases with anti-GBM Ab and ANCA have been described in the literature and the implication of these antibodies has been discussed [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Several reports suggested that ANCA-associated disease occurred initially and damaged the alveolar or glomerular basement membrane (BM), thus resulting in the release of alveolar or glomerular BM antigen (a 3 NC1 antigen) into the circulation [12,13,26,27].…”

Acute Interstitial Nephritis and Uveitis with Bone Marrow Granulomas and Anti-IMeutrophil Cytoplasmic Antibodies

“…2). The specificity of ANCA by ELISA test showed a negative reactivity for proteinase 3 (PR3) and myeloperoxidase (MPO) according to the method reported by Arintura et al [32]. Tests for CRP, anti-DNA, -SSA, and -SSB anti bodies, rheumatoid factor, and LE cells were negative.…”