Chirinos Julio A, Corrales-Medina Vicente F, Garcia Santiago, Lichtstein Daniel M, Bisno Alan L, Chakko Simon
Department of Medicine, University of Miami, School of Medicine and Veterans Affairs Medical Center, Miami, FL, USA.
Clin Rheumatol. 2007 Apr;26(4):590-5. doi: 10.1007/s10067-005-0176-z. Epub 2006 Jan 27.
We report a case of subacute bacterial endocarditis associated with small vessel vasculitis and a strongly positive cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) test. It is important to recognize this cause of positive c-ANCA because infectious endocarditis may closely mimic the clinical manifestations of ANCA-associated vasculitides such as Wegener granulomatosis or microscopic polyangiitis. Furthermore, ANCA-associated vasculitis may result in noninfectious endocarditis, which may be confused with bacterial endocarditis. In this paper, we review reported cases of ANCA-positive bacterial endocarditis and compare them to the reported cases of ANCA-associated idiopathic vasculitis with endocardial compromise.
我们报告一例亚急性细菌性心内膜炎，其与小血管血管炎以及胞浆抗中性粒细胞胞浆抗体（c-ANCA）检测呈强阳性相关。认识到c-ANCA阳性的这一病因很重要，因为感染性心内膜炎可能与ANCA相关血管炎（如韦格纳肉芽肿或显微镜下多血管炎）的临床表现极为相似。此外，ANCA相关血管炎可能导致非感染性心内膜炎，这可能与细菌性心内膜炎相混淆。在本文中，我们回顾已报道的ANCA阳性细菌性心内膜炎病例，并将其与已报道的伴有心内膜受累的ANCA相关特发性血管炎病例进行比较。
