Subra J F, Michelet C, Laporte J, Carrere F, Reboul P, Cartier F, Saint-André J P, Chevailler A
Service de Néphrologie, CHU Angers, France.
Clin Nephrol. 1998 Jan;49(1):15-8.
Antineutrophil cytoplasmic antibodies positivity with cytoplasmic pattern (C-ANCA) and proteinase-3 (PR-3) specificity was found in two patients with both subacute bacterial endocarditis (SBE) and glomerular involvement. Renal biopsy showed membranoproliferative glomerulonephritis in one case and focal segmental glomerulonephritis in the second case. Immunofluorescence study showed granular immune deposits in both cases evocating immune complex glomerulonephritis. Renal and biological manifestations disappeared with clinical improvement secondary to antibiotherapy. Physicians have to consider the possible occurrence of such C-PR-3 ANCA, claimed to be specific markers for Wegener's granulomatosis, in infectious diseases such as SBE. Hence we focus on the necessity of performing a renal biopsy with light microscopy and immunofluorescence studies in all patients with ANCA associated glomerular disease.
在两名患有亚急性细菌性心内膜炎（SBE）且有肾小球受累的患者中，发现抗中性粒细胞胞浆抗体呈胞浆型（C-ANCA）阳性且具有蛋白酶-3（PR-3）特异性。肾活检显示，一例为膜增生性肾小球肾炎，另一例为局灶节段性肾小球肾炎。免疫荧光研究显示，两例均有颗粒状免疫沉积物，提示免疫复合物性肾小球肾炎。随着抗生素治疗后临床症状改善，肾脏和生物学表现消失。医生必须考虑在诸如SBE等传染病中可能出现这种C-PR-3 ANCA，据称它是韦格纳肉芽肿的特异性标志物。因此，我们强调对于所有ANCA相关性肾小球疾病患者，进行肾活检并进行光学显微镜和免疫荧光研究的必要性。
