Kamar Fareed B, Hawkins T Lee-Ann
Department of Medicine, University of Calgary, Calgary, AB, Canada T2N 4N1.
Department of Medicine, Division of General Internal Medicine, University of Calgary, Calgary, AB, Canada T2N 4N1.
Can J Infect Dis Med Microbiol. 2016;2016:3585860. doi: 10.1155/2016/3585860. Epub 2016 Mar 21.
While antineutrophil cytoplasmic antibody (ANCA) is often used as a diagnostic marker for certain vasculitides, ANCA induction in the setting of infection is much less common. In the case of infective endocarditis, patients may present with multisystem disturbances resembling an autoimmune process, cases that may be rendered even trickier to diagnose in the face of a positive ANCA. Though not always straightforward, distinguishing an infective from an inflammatory process is pivotal in order to guide appropriate therapy. We describe an encounter with a 43-year-old male with chronically untreated hepatitis C virus infection who featured ANCA positivity while hospitalized with acute bacterial endocarditis. His case serves as a reminder of two of the few infections known to uncommonly generate ANCA positivity. We also summarize previously reported cases of ANCA positivity in the context of endocarditis and hepatitis C infections.
虽然抗中性粒细胞胞浆抗体（ANCA）常被用作某些血管炎的诊断标志物，但在感染情况下诱导产生ANCA的情况则要少见得多。就感染性心内膜炎而言，患者可能会出现类似于自身免疫过程的多系统紊乱，面对ANCA阳性时，这些病例的诊断可能会变得更加棘手。尽管并不总是一目了然，但区分感染性过程和炎症性过程对于指导适当的治疗至关重要。我们描述了一名43岁慢性丙型肝炎病毒感染未治疗的男性患者，他在因急性细菌性心内膜炎住院期间出现ANCA阳性。他的病例提醒我们注意少数已知会罕见地产生ANCA阳性的感染中的两种。我们还总结了先前报道的在心内膜炎和丙型肝炎感染背景下ANCA阳性的病例。
