Ara J, Mirapeix E, Rodríguez R, Pascual J, Alvarez L, Darnell A
Servicios de Nefrología, Hospital Clínic i Provincial, Barcelona.
Med Clin (Barc). 1998 Oct 31;111(14):536-8.
Analysis of usefulness of antineutrophil cytoplasmic antibodies (AN-CA) as a marker of clinical activity in small vessel vasculitis.
33 patients, 10 patients with Wegener's granulomatosis (WG) and 23 with microscopic polyangiitis (MPA) and rapidly progressive glomerulonephritis type III (RPGN III). The clinic and serologic follow-up was accomplished every 3 months during an average of 19 (SD, 24) months (range 3-52 months. The serologic follow-up included the determination of ANCA by indirect immunofluorescence (IFI) and ELISA, as well as the serum level of C reactive protein (RCP).
At the time of diagnosis all patients were ANCA positive by IFI and ELISA. The seroconversion of ANCA from positive to negative was produced in 30/33 patients (90%). Twenty-six out of these 30 patients (87%) achieved the seroconversion within the first 6 months. During the follow-up 4 patients had a major relapse, all with positive ANCA. In 2 patients, one of each group, seroconversion from negative to positive was not associated with clinical relapse of vasculitis.
ANCA should be used in conjunction with other indices of disease activity in patients with small vessel vasculitis.
分析抗中性粒细胞胞浆抗体（ANCA）作为小血管炎临床活动标志物的实用性。
33例患者，其中10例为韦格纳肉芽肿病（WG），23例为显微镜下多血管炎（MPA）和III型急进性肾小球肾炎（RPGN III）。在平均19（标准差，24）个月（范围3 - 52个月）期间，每3个月进行一次临床和血清学随访。血清学随访包括通过间接免疫荧光法（IFI）和酶联免疫吸附测定（ELISA）测定ANCA，以及血清C反应蛋白（RCP）水平。
诊断时所有患者通过IFI和ELISA检测ANCA均为阳性。33例患者中有30例（90%）出现ANCA从阳性转为阴性的血清学转换。这30例患者中有26例（87%）在最初6个月内实现了血清学转换。随访期间4例患者出现严重复发，所有复发患者ANCA均为阳性。每组各有1例患者，其ANCA从阴性转为阳性与血管炎临床复发无关。
在小血管炎患者中，ANCA应与其他疾病活动指标联合使用。
