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Antineutrophil cytoplasmic antibodies

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https://www.readbyqxmd.com/read/28109377/antineutrophil-cytoplasmic-antibody-associated-multiple-giant-saccular-aortic-aneurysms
#1
Ryoji Kinoshita, Tomohiro Mizuno, Tsuyoshi Hachimaru, Keiji Oi, Masafumi Yashima, Eiki Nagaoka, Tatsuki Fujiwara, Hidehito Kuroki, Dai Tasaki, Hirokuni Arai
We describe a very rare case of a 67-year-old man with multiple saccular aortic aneurysms throughout the entire aorta due to antineutrophil cytoplasmic antibody-associated vasculitis (AAV). The patient underwent staged aortic surgical procedures, including stent-graft insertion for a left iliac artery aneurysm, thoracic endovascular aortic repair for a descending aortic aneurysm, and total replacement of the ascending aorta and aortic arch with the use of high-dose steroids to control inflammation. The histologic findings demonstrated that the damage to the vasa vasorum of the adventitia resulting from AAV caused ischemia of the media, resulting in the formation of saccular aneurysmal changes...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28089971/incidence-of-malignancy-prior-to-antineutrophil-cytoplasmic-antibody-associated-vasculitis-compared-to-the-general-population
#2
Emma E van Daalen, Chinar Rahmattulla, Ron Wolterbeek, Jan A Bruijn, Ingeborg M Bajema
OBJECTIVE: Previous studies have reported an increased malignancy risk preceding antineutrophil cytoplasmic antibody-associated vasculitis (AAV), suggesting common pathogenic pathways in these 2 entities. However, the study results were conflicting and often limited to patients with granulomatosis with polyangiitis (GPA). Here, we study the malignancy risk prior to AAV diagnosis [either GPA or microscopic polyangiitis (MPA)] to elaborate on the putative association between malignancy and AAV...
January 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28087591/clinical-trials-in-antineutrophil-cytoplasmic-antibody-associated-vasculitis-what-we-have-learnt-so-far-and-what-we-still-have-to-learn
#3
Divi Cornec, Emilie Cornec-Le Gall, Ulrich Specks
The prognosis of the antineutrophil cytoplasmic antibody associated vasculitides (AAV), microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic GPA (EGPA), has been fundamentally improved over the last five decades by the use of glucocorticoids and immunosuppressants, turning them from consistently fatal diseases into chronic conditions. The long-term course is now largely determined by the frequency of disease flares and by accruing damage caused by disease activity and treatment-related comorbidities...
January 12, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28077133/t1-and-t2-mapping-for-evaluation-of-myocardial-involvement-in-patients-with-anca-associated-vasculitides
#4
Simon Greulich, Agnes Mayr, Daniel Kitterer, Joerg Latus, Joerg Henes, Hannah Steubing, Philipp Kaesemann, Alexandru Patrascu, Andreas Greiser, Stefan Groeninger, Niko Braun, M Dominik Alscher, Udo Sechtem, Heiko Mahrholdt
BACKGROUND: Myocardial involvement in AAV patients might be silent, presenting with no or nonspecific symptoms, normal ECG, and preserved left-ventricular ejection fraction (LV-EF). Since up to 50% of deaths in these patients may be due to myocardial involvement, a reliable diagnostic tool is warranted. In contrast to LGE-CMR, which has its strengths in detecting focal inflammatory or fibrotic processes, recent mapping techniques are able to detect even subtle, diffuse inflammatory or fibrotic processes...
January 6, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28076879/igm-antibodies-to-proteinase-3-in-granulomatosis-with-polyangiitis-and-microscopic-polyangiitis
#5
J M Clain, A M Hummel, J H Stone, F C Fervenza, G S Hoffman, C G M Kallenberg, C A Langford, W J McCune, P A Merkel, P A Monach, P Seo, R F Spiera, E W St Clair, S R Ytterberg, And U Specks
Antineutrophil cytoplasmic antibodies (ANCA) appear to play an important role in the pathogenesis of ANCA-associated vasculitis (AAV). Yet, ANCA alone are not sufficient to generate disease, and some evidence suggests that infectious triggers may serve as inciting events for AAV disease activity. Antibodies of the IgM isotype often serve as markers of recent infection, and IgM ANCA have previously been identified in patients with AAV, though the frequency and clinical relevance of IgM ANCA is not well established...
January 11, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28074992/-antineutrophil-cytoplasmic-antibody-anca-associated-renal-vasculitis-and-pregnancy-report-of-one-case
#6
Jorge Vega, Gonzalo P Méndez
ANCA mediated vasculitis mainly occur between the fourth and fifth decade of life; therefore, it is very uncommon to see pregnant patients with the disease. Vasculitis may affect significantly the course of pregnancy; in turn pregnancy can change the course of vasculitis. We report a 20 years old woman with ANCA-mediated renal vasculitis lasting 10 years who consulted with a pregnancy of 15 weeks. She was in remission and had amenorrhea attributed to ovarian toxicity due to cyclophosphamide. Pregnancy had an uneventful course with spontaneous delivery at the 37th week, giving birth to a healthy newborn...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28069788/proteinase-3-antineutrophil-cytoplasmic-antibody-positive-ulcerative-colitis-presenting-with-abducens-neuropathy
#7
Yuki Kirito, Daisuke Yamamoto, Tsuyoshi Uchiyama
A 72-year-old man with ulcerative colitis (UC) presented with complete left abducens nerve palsy. Although MRI showed no significant changes, cerebrospinal fluid analysis revealed pleocytosis and elevated protein and interleukin (IL)-6 levels. His serum proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) level was also elevated to 31.1 U/mL, but granulomatosis with polyangiitis was not observed. On the basis of the diagnosis of autoimmune cranial neuropathy, he was treated with steroid therapy. While tapering steroid therapy, his serum PR3-ANCA levels; cerebrospinal fluid findings, including IL-6 levels; and symptoms improved...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28065613/anca-negative-churg-strauss-syndrome-presenting-as-acute-multiple-cerebral-infarcts-a-case-report
#8
Klearchos Psychogios, Ilias Evmorfiadis, Spyros Dragomanovits, Athanasios Stavridis, Konstantinos Takis, Loukas Kaklamanis, Stathis Pantelis
Eosinophilic granulomatosis with polyangiitis (EGPA, previously named Churg-Strauss syndrome) is a form of necrotizing vasculitis occurring in patients with asthma and eosinophilia. Ischemic stroke is a relatively rare complication of the disease. We report a case of a 63-year-old woman with multiple embolic infarcts, hypereosinophilia (for >7 years), and skin rash. Elevated cardiac enzymes and cardiac magnetic resonance imaging were consistent with endomyocarditis. The simultaneous presence of history of asthma, sinusitis, hypereosinophilia, and vasculitis led to the diagnosis of EGPA...
January 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28058500/-paradigm-shift-in-anca-diagnostics-new-international-consensus-recommendations
#9
REVIEW
E Csernok, N Kempiners, B Hellmich
BACKGROUND: Up to now indirect immunofluorescence (IIF) followed by an antigen-specific assay specific for proteinase 3 (PR3) or myeloperoxidase (MPO) has been the standard method for the detection of antineutrophil cytoplasmic antibodies (ANCA). The development of more sensitive and highly specific PR3-ANCA and MPO-ANCA immunoassays for the diagnosis of ANCA-associated vasculitis (AAV) has raised doubts about the two-stage diagnostic strategy currently recommended for ANCA detection...
January 5, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27980013/histopathological-classification-and-renal-outcome-in-patients-with-antineutrophil-cytoplasmic-antibodies-associated-renal-vasculitis-a-study-of-186-patients-and-metaanalysis
#10
Yong-Xi Chen, Jing Xu, Xiao-Xia Pan, Ping-Yan Shen, Xiao Li, Hong Ren, Xiao-Nong Chen, Li-Yan Ni, Wen Zhang, Nan Chen
OBJECTIVE: Renal vasculitis is one of the most common manifestations of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) and renal histology is a key predictor of the outcome. A new histopathologic classification was proposed and validated, but the results are still debated. METHODS: We performed a retrospective analysis to validate the histopathologic classification and performed a metaanalysis to evaluate its predictive value. There were 186 patients with ANCA-associated renal vasculitis diagnosed at Ruijin Hospital who were enrolled in the retrospective study...
December 15, 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27933390/-de-escalation-of-therapy-in-anca-associated-vasculitides
#11
REVIEW
S Schinke, G Riemekasten, P Lamprecht
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) require a differentiated therapeutic approach depending on the degree of organ dysfunction and disease activity. In organ dysfunction and life-threatening AAV cyclophosphamide and rituximab are recommended for the induction of remission. For remission induction with a lack of organ dysfunction and non-life-threatening AAV, methotrexate or mycophenolate mofetil are recommended. For remission maintenance therapy azathioprine or methotrexate are used...
December 8, 2016: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27922762/nonchemotherapy-drug-induced-agranulocytosis-in-children-detected-by-a-prospective-pharmacovigilance-program
#12
Nicolás Medrano-Casique, Hoi Y Tong, Alberto M Borobia, Antonio J Carcas, Jesús Frías, Elena Ramírez
OBJECTIVES: A prospective evaluation of nonchemotherapy drug-induced agranulocytosis (DIA) cases, which are infrequent in the pediatric population. We characterize agranulocytosis cases and assess lab test differences between drug- and nondrug-induced agranulocytosis. METHODS: Through our Prospective Pharmacovigilance Program from Laboratory Signals at Hospital we detected pediatric agranulocytosis cases from July 2007 to December 2010. This program estimates the incidence, drug causality, clinical features, outcomes of DIA pediatric cases, and assesses laboratory differences with respect to non-DIA...
October 2016: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/27920658/isolated-bilateral-gastrocnemius-myositis-in-crohn-disease-successfully-treated-with-adalimumab
#13
Salvatore Vadala di Prampero, Marco Marino, Francesco Toso, Claudio Avellini, Vu Nguyen, Dario Sorrentino
Extraintestinal manifestations are common in inflammatory bowel disease; however, muscular involvement in Crohn disease is rarely reported. We present a case of a 26-year-old male with ileocolonic Crohn disease who developed sudden tenderness in both calves. Doppler ultrasound was negative for deep vein thrombosis. Magnetic resonance imaging of the gastrocnemius muscle showed high intensity signal in the muscle fibers, and muscle biopsy demonstrated nonspecific lymphocytic myositis. Other relevant laboratory results included normal antineutrophil cytoplasmic antibodies and creatine kinase as well as elevated C-reactive protein, erythrocyte sedimentation rate, and anti-Saccharomyces cerevisiae IgG titer...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27919708/early-interstitial-lung-disease-in-microscopic-polyangiitis-case-report-and-literature-review
#14
Marcos García-Nava, Heidegger Mateos-Toledo, Ana Patricia Georgina Guevara-Canseco, Cesar Eduardo Infante-González, Diego Alberto Reyes-Nava, Emilio Estrada-Castro
Microscopic polyangiitis (MPA) is a systemic disease included in the Chapel Hill 2012 Classification as necrotizing vasculitis affecting capillaries, venules and arterioles. It usually expresses antineutrophil cytoplasmic antibodies (ANCA) and has a perinuclear immunofluorescence pattern and correlation with anti-myeloperoxidase (MPO) antibodies. Capillaritis with alveolar hemorrhage is the most common manifestation of lung disease. Interstitial lung disease (ILD) is uncommon, with usual interstitial pneumonia being the predominant pattern...
December 2, 2016: Reumatología Clinica
https://www.readbyqxmd.com/read/27904127/hla-b52-positive-aortitis-with-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#15
Kohei Karino, Michihito Kono
No abstract text is available yet for this article.
2016: Internal Medicine
https://www.readbyqxmd.com/read/27904110/infected-aortic-aneurysm-mimicking-anti-proteinase-3-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#16
Kenta Hachiya, Kazuaki Wakami, Atsuhiro Yoshida, Hisao Suda, Nobuyuki Ohte
We herein report an unusual case of an infected descending aortic pseudoaneurysm with luminal pathognomonic oscillating vegetation with serological findings and clinical features mimicking anti-proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis. The positive blood cultures and imaging findings, including a pseudoaneurysm and vegetations in the aorta, suggested the presence of an infected aortic aneurysm. The patient was successfully treated with antibiotics and endovascular aortic repair...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27899427/a-56-year-old-woman-with-breathlessness
#17
Alastair J Moss, Marc R Dweck, Peter D O'Kane
CLINICAL INTRODUCTION: A 56-year-old female with adult-onset asthma was admitted to the cardiology service with intermittent left-sided chest pain and progressive dyspnoea. Twelve months prior to this admission, she had received a course of prednisolone for bilateral anterior uveitis. Physical examination was unremarkable with blood sampling revealing a marked eosinophilia (eosinophil count 17.3×10(9)/L) and a perinuclear antineutrophil cytoplasmic antibody staining pattern on indirect immunofluorescence microscopy (myeloperoxidase antibodies 83 IU/mL)...
November 29, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27899372/effect-of-rituximab-on-malignancy-risk-in-patients-with-anca-associated-vasculitis
#18
Emma E van Daalen, Raffaella Rizzo, Andreas Kronbichler, Ron Wolterbeek, Jan A Bruijn, David R Jayne, Ingeborg M Bajema, Chinar Rahmattulla
OBJECTIVES: Patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) treated with cyclophosphamide have an increased malignancy risk compared with the general population. We investigated whether treatment with rituximab instead of cyclophosphamide has decreased the malignancy risk in patients with AAV. METHODS: The study included patients with AAV treated at a tertiary vasculitis referral centre between 2000 and 2014. The malignancy incidence in these patients was compared with the incidence in the general population by calculating standardised incidence ratios (SIRs), adjusted for sex, age and calendar year...
November 29, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27876769/gastrointestinal-aspects-of-vasculitides
#19
REVIEW
Medha Soowamber, Adam V Weizman, Christian Pagnoux
Systemic vasculitides are caused by inflammation of blood vessels and can affect any organ and any part of the gastrointestinal tract, hepatic and biliary system, as well as the pancreas. These disorders can cause a wide array of gastrointestinal manifestations, from asymptomatic elevated transaminase levels and mild abdominal pain to potentially life-threatening bowel perforations and peritonitis. A diagnosis based solely on gastrointestinal symptoms is challenging as these manifestations are not specific...
November 23, 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27872837/antineutrophil-cytoplasmic-antibodies-crescentic-allograft-glomerulonephritis-after-sofosbuvir-therapy
#20
Shilpa Gadde, Belinda Lee, Laura Kidd, Rubin Zhang
Antineutrophil cytoplasmic antibodies (ANCA) are well known to be associated with several types of vasculitis, including pauci-immune crescentic glomerulonephritis, a form of rapid progressive glomerular nephritis (RPGN). ANCA vasculitis has also been reported after administration of propylthiouracil, hydralazine, cocaine (adulterated with levimasole), allopurinol, penicillamine and few other drugs. All previously reported cases of drug-associated ANCA glomerulonephritis were in native kidneys. Sofosbuvir is a new and effective drug for hepatitis C virus infection...
November 6, 2016: World Journal of Nephrology
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