Antineutrophil Cytoplasmic Antibody Induction due to Infection: A Patient with Infective Endocarditis and Chronic Hepatitis C

Kamar, Fareed; Hawkins, T. Lee-Ann

doi:10.1155/2016/3585860

Cited by 10 publications

(10 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One might hypothesize that the inhibitory activity of anti-peroxidasin autoantibodies may contribute to the higher rate of bacterial infection observed in double-positive patients. However, ANCA may be positive in infectious processes, particularly in bacterial endocarditis [41][42][43][44]. The link between ANCA and infection is complex and would require further investigations, but previous publications have hypothesized that ANCA may be induced by antigenic stimulation secondary to neutrophilic enzymes released at the site of infection [43].…”

Section: Discussionmentioning

confidence: 99%

Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study

Caillard

Vigneau

Hazzan

et al. 2020

JCM

View full text Add to dashboard Cite

In patients presenting with anti-glomerular basement membrane (GBM) disease with advanced isolated kidney involvement, the benefit of intensive therapy remains controversial due to adverse events, particularly infection. We aim to describe the burden of severe infections (SI) (requiring hospitalization or intravenous antibiotics) and identify predictive factors of SI in a large cohort of patients with anti-GBM disease. Among the 201 patients (median [IQR] age, 53 [30–71] years) included, 74 had pulmonary involvement and 127 isolated glomerulonephritis. A total of 161 SI occurred in 116 patients during the first year after diagnosis. These infections occurred during the early stage of care (median [IQR] time, 13 [8–19] days after diagnosis) with mainly pulmonary (45%), catheter-associated bacteremia (22%) and urinary tract (21%) infections. In multivariable analysis, positive ANCA (HR [95% CI] 1.62 [1.07−2.44]; p = 0.02) and age at diagnosis (HR [95% CI] 1.10 [1.00–1.21]; p = 0.047) remained independently associated with SI. Age-adjusted severe infection during the first three months was associated with an increased three-year mortality rate (HR [95% CI] 3.13 [1.24–7.88]; p = 0.01). Thus, SI is a common early complication in anti-GBM disease, particularly in the elderly and those with positive anti-neutrophil cytoplasmic antibodies (ANCA). No significant association was observed between immunosuppressive strategy and occurrence of SI.

show abstract

Section: Discussionmentioning

confidence: 99%

Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study

Caillard

Vigneau

Hazzan

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…IE is a mimicker of vasculitis. Immunological phenomena of IE may result in a positivity of cryoglobulin, ANCA, and rheumatoid factor that will become negative once the infection is completely treated (6).…”

Section: Discussionmentioning

confidence: 99%

Bacillus cereus Subacute Native Valve Infective Endocarditis and Its Multiple Complications

Nallarajah

Mujahieth

2020

Case Reports in Cardiology

View full text Add to dashboard Cite

Bacillus cereus causing infective endocarditis (IE) in a native valve is an extremely rare event, but it is reported mostly in intravenous drug abusers and other risk factors as immunosuppression, malignancy, and valvular heart disease including prosthetic heart valves. We report a case of B.cereus native mitral valve infective endocarditis in a 58-year-old Sri Lankan male who is not a drug abuser who presented with painless hematuria with reduced urine output. During hospital stay, he developed frequent episodes of brief focal seizures. He had undergone multiple investigations that revealed splenic abscesses, cerebral vasculitis, and glomerular nephritis with positive rheumatoid factor, cytoplasmic antineutrophil cytoplasmic antibody (C-ANCA), and cryoglobulin. The appropriate antibiotic was the prime therapeutic intervention which carried an excellent prognosis. This case highlights an unusual organism in the blood culture that caused IE warranting thorough physical examination and investigations.

show abstract

“…This table was adapted from Kamar and Hawkins [7], with additional information specific to cases with hepatitis C, cryoglobulinemia, and ANCA-associated disease.…”

Section: Discussionmentioning

confidence: 99%

“…The targets of the ANCA antibodies are PR3 and cathepsin G in these chronically infected patients [ 6 ]. In comparison with hepatitis B infection, which is more commonly associated with large vessel disease (polyarteritis nodosa, PAN), HCV infection is predominantly associated with small vessel vasculitis (microsocopic polyangitis, MPA) [ 4 , 7 , 8 , 9 , 10 ]. Although both PAN and MPA are p-ANCA-associated processes, they are distinguished from each other by size of affected arteries [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…This may be due to false positive autoimmune assays in HCV infection, which are present in a high number of infected patients [ 16 ]. Nevertheless, c-ANCA and p-ANCA autoantibodies do seem to have an etiologic link to chronic infections such as HCV infection, and have been associated with biopsy-proven ANCA-associated vasculitis [ 7 , 17 , 18 , 19 ]. In HCV-infected patients, ANCA titers appear to be related to viremia, likely due to an errant immune response secondary to HCV infection [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Case Report: Patient with Hepatitis C, p-ANCA, and Cryoglobulin Antibodies Presenting with Necrotizing Crescentic p-ANCA Glomerulonephritis

Hanna

So²,

Kaldas

et al. 2018

Case Rep Nephrol Dial

View full text Add to dashboard Cite

Hepatitis C (HCV) infection has a prevalence of 3 million infected individuals in the United States, according to recent Center for Disease Control reports, and can have various renal manifestations. Cryoglobulins, antibodies that precipitate at colder temperatures in vitro, are a relatively common cause of renal disease in HCV infection. The cryoglobulin proteins can form occlusive aggregates in small glomerular capillary lumina or deposit in other areas of the glomerulus, resulting in hypocomplementemia, proteinuria, hematuria, and renal injury. The typical biopsy pattern is that of membranoproliferative glomerulonephritis (MPGN). There are, however, other HCV-related patterns of glomerular injury. Anti-neutrophil cytoplasmic antibodies (ANCA) are known to exist in HCV-infected patients. In many reported cases, ANCA serologic testing may appear positive due to cross-reactivity of the immune assays; however, the biopsy findings do not support ANCA-associated crescentic glomerulonephritis (GN)/vasculitis as the primary cause of glomerular injury. There are rare reports of microscopic polyangiitis (MPA) p-ANCA vasculitis, in patients with HCV infection. In comparison with the MPGN pattern of cryoglobulinemic glomerular injury, biopsies from these HCV-infected patients with concomitant MPA revealed a crescentic GN, associated with normal serum complement levels. We present a case of HCV-associated glomerular disease with the surprising biopsy finding of necrotizing and crescentic p-ANCA GN, with a background, low-grade mesangial immune complex GN. Thus, p-ANCA disease should also be considered in HCV-infected patients, in addition to the more typical lesions of MPGN or cryoglobulinemic GN.

show abstract

Antineutrophil Cytoplasmic Antibody Induction due to Infection: A Patient with Infective Endocarditis and Chronic Hepatitis C

Cited by 10 publications

References 44 publications

Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study

Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study

Bacillus cereus Subacute Native Valve Infective Endocarditis and Its Multiple Complications

Case Report: Patient with Hepatitis C, p-ANCA, and Cryoglobulin Antibodies Presenting with Necrotizing Crescentic p-ANCA Glomerulonephritis

Contact Info

Product

Resources

About