Tateyama Kaori, Kodama Satoru, Nomi Nozomi, Suzuki Masashi, Kishibe Kan, Harabuchi Yasuaki
Nihon Jibiinkoka Gakkai Kaiho. 2015 Sep;118(9):1133-42. doi: 10.3950/jibiinkoka.118.1133.
Otitis media related with ANCA associated vasculitis is an intractable condition conditions that is resistant to conventional conservative treatment or surgical treatments. The name "otitis media with ANCA associated vasculitis (OMAAV)" has been proposed as a new concept for this disease. In the present study, we examined the clinical feature of 14 cases of OMAAV. We also investigated the usefulness of combined tests for ANCA detection. There were 11 females and 3 males, with a median age of 68.5 years. PR3-ANCA was positively detected in 4 (28.6%) patients, MPO-ANCA was detected in 6 (42.9%), and 4 (28.6%) were both ANCAs negative. During the course 6 patients developed pachymeningitis and 5 patients developed facial palsy. Plasma samples from 14 OMAAV patients were tested for the presence of ANCAs with five detection methods (3 PR 3-ANCA kits (direct ELISA, capture ELISA, anchor ELISA), 2 MPO-ANCA kits (direct ELISA, capture ELISA)) and the indirect immunofluorescence (II) technique. Six patients (42.9%) were positive for ANCA in clinical examination (single EIA method), while ANCA was positively detected in 9 patients (64.3%) with combined methods. In ANCA negative cases, ANCA should also be tested with a different technique such as new generation ELISA and IIF.
与抗中性粒细胞胞浆抗体（ANCA）相关血管炎相关的中耳炎是一种难治性疾病，对传统保守治疗或手术治疗均有抵抗。“ANCA相关血管炎伴中耳炎（OMAAV）”这一名称已被提出作为该疾病的新概念。在本研究中，我们检查了14例OMAAV患者的临床特征。我们还研究了联合检测ANCA的实用性。患者中有11名女性和3名男性，中位年龄为68.5岁。4例（28.6%）患者PR3-ANCA检测呈阳性，6例（42.9%）检测到MPO-ANCA，4例（28.6%）两种ANCA均为阴性。病程中，6例患者发生了硬脑膜炎，5例患者发生了面神经麻痹。采用五种检测方法（3种PR 3-ANCA试剂盒（直接酶联免疫吸附测定法、捕获酶联免疫吸附测定法、锚定酶联免疫吸附测定法）、2种MPO-ANCA试剂盒（直接酶联免疫吸附测定法、捕获酶联免疫吸附测定法））和间接免疫荧光（II）技术对14例OMAAV患者的血浆样本进行ANCA检测。临床检查（单一酶免疫测定法）中6例患者（42.9%）ANCA呈阳性，而联合检测方法中9例患者（64.3%）ANCA检测呈阳性。在ANCA阴性的病例中，也应用不同技术（如新一代酶联免疫吸附测定法和免疫荧光法）检测ANCA。
