Soler C, Dupré-Goudable C, Rey J P, Modesto A, Oksman F, Suc J M
Laboratoire d' auto-immunité, CHU Purpan, Toulouse, France.
Ann Biol Clin (Paris). 1993;51(2):133-9.
We present a retrospective study of all patients with a positive anti-neutrophil cytoplasm autoantibodies (ANCA) result from July 1987 to December 1990. The aims of the study were to assess specificity of ANCA in renal vasculitis and to correlate ANCA immunofluorescence subtypes with clinical aspect, diagnosis, severity and outcome. Anti-myeloperoxidase antibody (A-MPO) was sought in 31 cases. Specificity was 86% and false-positive results were 11%. ANCA subtypes varied with the clinical picture. C-ANCA were more often present when renal vasculitis was associated with pulmonary and ear, nose and throat involvement; P-ANCA were more often present when there was no respiratory tract involvement. Thus C-ANCA were preferentially associated with Wegener's granulomatosis and P-ANCA with microscopic polyarteritis and pauci-immune necrotizing and crescentic glomerulonephritis. No correlation was found between ANCA subtypes and severity or outcome. A-MPO were positive in 14 cases (especially in micropolyarteritis and necrotizing glomerulonephritis).
我们对1987年7月至1990年12月间抗中性粒细胞胞浆自身抗体(ANCA)检测结果呈阳性的所有患者进行了一项回顾性研究。该研究的目的是评估ANCA在肾血管炎中的特异性,并将ANCA免疫荧光亚型与临床情况、诊断、严重程度及预后相关联。在31例患者中检测了抗髓过氧化物酶抗体(A-MPO)。其特异性为86%,假阳性结果为11%。ANCA亚型随临床症状而异。当肾血管炎伴有肺部及耳鼻喉受累时,C-ANCA更常出现;当无呼吸道受累时,P-ANCA更常出现。因此,C-ANCA优先与韦格纳肉芽肿病相关,而P-ANCA与显微镜下多动脉炎及少免疫性坏死性新月体性肾小球肾炎相关。未发现ANCA亚型与严重程度或预后之间存在相关性。14例患者A-MPO呈阳性(尤其在显微镜下多动脉炎和坏死性肾小球肾炎中)。