Antineutrophil Cytoplasmic Antibodies Associated With Infective Endocarditis

Abstract

To determine the prevalence of antineutrophil cytoplasmic antibodies (ANCA) in patients with infective endocarditis (IE) in internal medicine; and to compare clinical and biochemical features and outcome between patients exhibiting IE with and without ANCA.Fifty consecutive patients with IE underwent ANCA testing. The medical records of these patients were reviewed.Of the 50 patients with IE, 12 exhibited ANCA (24%). ANCA-positive patients with IE exhibited: longer duration between the onset of first symptoms and IE diagnosis (P = 0.02); and more frequently: weight loss (P = 0.017) and renal impairment (P = 0.08), lower levels of C-reactive protein (P = 0.0009) and serum albumin (P = 0.0032), involvement of both aortic and mitral valves (P = 0.009), and longer hospital stay (P = 0.016). Under multivariate analysis, significant factors for ANCA-associated IE were: longer hospital stay (P = 0.004), lower level of serum albumin (P = 0.02), and multiple valve involvement (P = 0.04). Mortality rate was 25% in ANCA patients; death was because of IE complications in all these patients.Our study identifies a high prevalence of ANCA in unselected patients with IE in internal medicine (24%). Our findings further underscore that ANCA may be associated with a subacute form of IE leading to multiple valve involvement and more frequent renal impairment. Because death was due to IE complications in all patients, our data suggest that aggressive therapy may be required to improve such patients’ outcome.

Staphylococcus Infection–Associated GN – Spectrum of IgA Staining and Prevalence of ANCA in a Single-Center Cohort

“…Presence of ANCA has been previously reported in 18%-33% of patients with infective endocarditis (21)(22)(23)(24)(25)(26). A recent prospective study by Langlois et al (27) on 50 consecutive patients with infective endocarditis found 12 (24%) to be ANCA positive. Thus, ANCA vasculitis also enters the differential diagnosis, especially for staphylococcal endocarditis.…”

Microwave processing of camu‐camu juices: Physicochemical and microbiological parameters

“…It is noted that all microwave treatments increased the ascorbic acid content available in the juice compared to the nontreated juice. Compared to conventional methods, microwave processing provides heat transfer in food, and the nutrients, vitamins, taste and sensory characteristics, and color of food are well preserved (Ahmed & Ramaswamy, 2007). Furthermore, the conventional technical treatment reduced significantly (p < 0.05) in relation to the control juice.…”

Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis

“…Evidence suggests that infections have a central role in the formation of ANCAs and that chronic infections mimic AAV 99 ; infective endocarditis can mimic ANCA-associated glomerulonephritis and patients with infective endocarditis can develop ANCAs. Langlois et al 100 reported ANCAs by IIF in 12 out of 50 patients (24%) with infective endocarditis; four patients had PR3-ANCAs, one patient had MPO-ANCAs and two patients had both PR3-ANCAs and MPO-ANCAs. Mahr et al 101 reported ANCA by IIF in 20 out of 109 patients (18%) with infective endocarditis (14 patients were positive for C-ANCA and six were positive for P-ANCA); of these, three patients had C-ANCA and PR3-ANCAs, two patients had C-ANCA and MPOANCAs, one patient had P-ANCA and MPO-ANCAs, one patient had just PR3-ANCAs and one patient had just MPO-ANCAs.…”