Salerno S M, Ormseth E J, Roth B J, Meyer C A, Christensen E D, Dillard T A
Department of Medicine, Madigan Army Medical Center, Tacoma, Wash 98431-5000, USA.
Chest. 1996 Aug;110(2):556-9. doi: 10.1378/chest.110.2.556.
The centrally accentuated antineutrophil cytoplasmic antibody test (c-ANCA) is widely regarded as a sensitive and specific marker for Wegener's granulomatosis (WG). There are increasing reports, however, of false-positive c-ANCAs, usually in the setting of other vasculidities. We report a case of a 27-year-old man with ulcerative colitis who developed pulmonary symptoms, peripheral nodular lung infiltrates, and an elevated c-ANCA suggesting WG. Chest CT and open lung biopsy specimens were consistent with WG. The symptoms and pulmonary infiltrates resolved after discontinuation of sulfasalazine therapy. The c-ANCA remained elevated due to the occurrence of false-positive values in ulcerative colitis. We conclude sulfasalazine toxicity can mimic clinical aspects of WG and that c-ANCA testing should be interpreted with caution in patients with ulcerative colitis.
中心型抗中性粒细胞胞浆抗体检测（c-ANCA）被广泛认为是韦格纳肉芽肿（WG）的敏感且特异的标志物。然而，关于假阳性c-ANCA的报道越来越多，通常出现在其他血管炎的情况下。我们报告一例27岁溃疡性结肠炎男性患者，该患者出现肺部症状、外周结节性肺浸润以及c-ANCA升高，提示韦格纳肉芽肿。胸部CT和开放性肺活检标本与韦格纳肉芽肿相符。停用柳氮磺胺吡啶治疗后，症状和肺部浸润消失。由于溃疡性结肠炎出现假阳性值，c-ANCA仍保持升高。我们得出结论，柳氮磺胺吡啶毒性可模拟韦格纳肉芽肿的临床症状，对于溃疡性结肠炎患者，c-ANCA检测结果应谨慎解读。
