Nephrology Dialysis Transplantation, Vol 14, Issue 7 1667-1672, Copyright © 1999 by Oxford University Press
J Ara, E Mirapeix, R Rodriguez, A Saurina and A Darnell
Background: We analysed the usefulness of
anti-neutrophil cytoplasmic antibodies (ANCA) as a marker of clinical
activity in patients with small vessel vasculitis associated with
anti-myeloperoxidase (MPO) ANCA. Methods: We studied a
group of 25 patients, 15 with microscopic polyangitis and 10 with renal
limited vasculitis, so-called rapidly progressive glomerulonephritis type
III. The clinical and serological follow-up was accomplished quarterly over
an average of 2.79±2.08 years (range 0.25-6 years). ANCA was
analysed by indirect immunofluorescence ad enzyme-linked immunosorbent
assays (ELISAs). Results: At the time of diagnosis,
all patients were ANCA positive (P-ANCA and anti-MPO). Following a
standardized treatment, all patients except one achieved complete remission
of vasculitis in <3 months. One patient suddenly died during the
active phase (1 month of follow-up) and with positive ANCA. Seroconversion
from positive to negative occurred in 24/25 patients (96%). Eighteen of
these 24 patients (75%) achieved the seroconversion within the first 6
months. During the follow-up, two patients had four major relapses, all of
them associated with positive ANCA. ANCA seroconversion from negative to
positive was observed in one patient with microscopic polyangitis without
clinical relapse of vasculitis. Conclusion: ANCA
should be used in conjunction with other markers of disease activity in the
management of microscopic polyangitis and renal limited vasculitis patients
with anti-MPO ANCA. Key words: vasculitis; ANCA;
clinical evolution
ORIGINAL ARTICLES
Relationship between ANCA and disease activity in small vessel vasculitis patients with anti-MPO ANCA
Servei de Nefrologia, Hospital Clínic of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain; Corresponding author
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