Antineutrophil cytoplasmic antibodies

Hoffman, Gary S.; Specks, Ulrich

doi:10.1002/1529-0131(199809)41:9<1521::aid-art2>3.0.co;2-a

Cited by 375 publications

(161 citation statements)

References 188 publications

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“…Eleven candidate biomarkers, selected for ANCAs were not evaluated in the INSSYS study, but these autoantibodies also function poorly as biomarkers. Between 10% and 40% of all WG patients with active disease lack these antibodies altogether (25). Moreover, although persistent ANCA positivity appears to predict an increased likelihood of a disease flare at some point in the future, it does not predict the timing of such a flare and is not a reliable guide to therapy (25,26).…”

Section: Discussionmentioning

confidence: 99%

A serum proteomic approach to gauging the state of remission in Wegener's granulomatosis

Stone

Rajapakse

Hoffman

et al. 2005

Arthritis & Rheumatism

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Objective. To identify serum ion patterns that distinguish remission from active disease in patients with Wegener's granulomatosis (WG).Methods. Using sera collected in the WG Etanercept Trial, we selected samples from patients who either were undergoing a period of extended disease remission or had recent flares of active WG. Unfractionated samples were randomized into sets for training and testing, such that remission sera and active disease sera could be analyzed without batch bias. Molecular species within the sera were ionized by high-resolution, matrixassisted laser desorption ionization time-of-flight mass spectrometry. We then used a bioinformatics patternrecognition tool to identify optimal combinations of ions. During the training stage, the clinical data (remission versus active disease) were provided in association with the spectral data from each sample. In the testing stage, we performed blinded testing on a previously unexamined set of samples.Results Conclusion. This serum proteomic profiling approach appears to be useful in distinguishing between states of stable clinical remission and active disease.

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Section: Discussionmentioning

confidence: 99%

A serum proteomic approach to gauging the state of remission in Wegener's granulomatosis

Stone

Rajapakse

Hoffman

et al. 2005

Arthritis & Rheumatism

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“…However, 20 % of patients with GPA or MPA have the alternative ANCA, and at least 10 % of patients are ANCA negative [3][4][5]. In many cases, the ANCA titer will decrease or be 0 with remission induction therapy [4,6,7]. The main pathologic difference between GPA and MPA is the absence of granulomatous inflammation in MPA.…”

Section: Discussionmentioning

confidence: 99%

A case of (double) ANCA-negative granulomatosis with polyangiitis (Wegener’s)

et al. 2012

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A 60-year-old man had experienced cough, bloody sputum, and a 38°C fever for 1.5 months. He visited an outpatient clinic and received antibiotics and nonsteroidal anti-inflammatory drugs. However, because the symptoms continued, he visited our hospital. The past medical history included chronic sinusitis, hypertension, and diabetes mellitus. A chest x-ray film and computed tomography showed multiple pulmonary nodules with cavities.

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“…By IIF, P-ANCA may be identified in patients with systemic lupus erythematosus and may be difficult to distinguish from ANA (2,3,15,35,36,83). P-ANCA can be seen in various connective tissue diseases, such as in rheumatoid arthritis, inflammatory arthritis, progressive systemic sclerosis, and other disorders (4,33,38,84). In rheumatoid arthritis, granulocyte-specific ANA can closely resemble P-ANCA in IIF tests (3,5,38,82).…”

Section: Discussionmentioning

confidence: 99%

“…The pulmonary diseases that are most frequently associated with ANCA include Wegener's granulomatosis (WG), microscopic polyangiitis (MPA), Churg Strauss syndrome, and other disorders (2)(3)(4)(5). Elevated ANCA titers particularly occur during disease exacerbation but may be low or absent in remission (3,6,7).…”

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Antineutrophil Cytoplasmic Autoantibody in the Absence of Wegener's Granulomatosis or Microscopic Polyangiitis: Implications for the Surgical Pathologist

Gal

Velasquez

2002

Modern Pathology

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Antineutrophil cytoplasmic antibodies (ANCA) are useful serologic markers for the diagnosis and management of patients with Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA). However, problems in diagnosis and classification may occur when patients with other disorders develop ANCA. A 7-year review (1993-1999) disclosed 247 patients whose sera tested positively for ANCA by an indirect immunofluorescence method: 166 patients for cytoplasmic-ANCA (C-ANCA) and 81 patients for perinuclear-ANCA (P-ANCA) Twenty-seven patients had active pulmonary disease and underwent openlung biopsy or transbronchial biopsy. Eight patients (30%) had a disease other than WG or MPA, and their clinical, pathological, and serological findings were reviewed. The patients, all women, ranged in age from 28 to 77 years (median, 37 y). Dyspnea (n ‫؍‬ 6), cough (n ‫؍‬ 6), chest pain (n ‫؍‬ 2), and/or hemoptysis (n ‫؍‬ 2) were present. The duration of symptoms lasted from 3 weeks to 6 years (median, 6 mo). ANCA titers were C-ANCA (n ‫؍‬ 4; range, 1:40 -1280) or P-ANCA (n ‫؍‬ 4; range, 1:40 -640). The lung biopsies disclosed nonspecific interstitial pneumonia (n ‫؍‬ 4), bronchiolitis obliterans organizing pneumonia (n ‫؍‬ 1), diffuse alveolar damage (n ‫؍‬ 1), organizing diffuse alveolar hemorrhage without capillaritis (n ‫؍‬ 1), and necrotic granuloma (n ‫؍‬ 1). No cases showed characteristic histology for WG or MPA. The final diagnoses were various connective tissue disorders (n ‫؍‬ 5), chronic hypersensitivity pneumonia (n ‫؍‬ 1), postinfectious bronchitis/bronchiectasis (n ‫؍‬ 1), and ulcerative colitis-related lung disease (n ‫؍‬ 1). Surgical pathologists should be aware that significantly elevated ANCA titers may be associated with diverse forms of pulmonary disease. ANCA positivity alone, in the absence of appropriate clinical or pathologic findings, should not be used to substantiate a diagnosis of WG or MPA.

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Antineutrophil cytoplasmic antibodies

Cited by 375 publications

References 188 publications

A serum proteomic approach to gauging the state of remission in Wegener's granulomatosis

A serum proteomic approach to gauging the state of remission in Wegener's granulomatosis

A case of (double) ANCA-negative granulomatosis with polyangiitis (Wegener’s)

Antineutrophil Cytoplasmic Autoantibody in the Absence of Wegener's Granulomatosis or Microscopic Polyangiitis: Implications for the Surgical Pathologist

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