Clinical significance of myeloperoxidase-anti-neutrophil cytoplasmic antibody in idiopathic interstitial pneumonias.

Abstract

OBJECTIVE:

Although a possible association among myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA), microscopic polyangiitis (MPA), and idiopathic pulmonary fibrosis (IPF) has been suggested, the clinical significance of MPO-ANCA in idiopathic interstitial pneumonias (IIPs), including IPF and non-IPF, remains unclear. We aimed to investigate the frequency of MPO-ANCA positivity, as well as MPA incidence and risk factors for development in patients initially diagnosed with IIP.

METHODS:

We retrospectively analysed 305 consecutive patients who were initially diagnosed as IIP and had MPO-ANCA results available.

RESULTS:

Of the 305 patients, 26 (8.5%) were MPO-ANCA-positive. Baseline characteristics were similar between the MPO-ANCA-positive and -negative patients. The cumulative 5-year MPA incidence was 24.3% in the MPO-ANCA-positive patients and 0% in the -negative patients (P < 0.0001). MPO-ANCA was positive in 15 of 133 (11.3%) patients initially diagnosed with IPF and in 11 of 172 (6.3%) patients initially diagnosed with non-IPF (P = 0.56), with cumulative 5-year MPA incidence of 6.2% and 1.0%, respectively (P = 0.10). Multivariate analysis revealed that UIP pattern on HRCT (HR = 3.20, P < 0.01) and no treatment for IIP (HR = 3.52, P < 0.01) were independently associated with MPA development in MPO-ANCA-positive patients.

CONCLUSION:

MPO-ANCA positivity was uncommon, but was associated with subsequent MPA development in patients initially diagnosed with IIP, including both IPF and non-IPF cases. The study suggested that attention should be paid to MPA development in MPO-ANCA-positive IIP patients with UIP pattern on HRCT and those without treatment for IIP.

• Authors: Hironao Hozumi, Yoshiyuki Oyama, Hideki Yasui, Yuzo Suzuki, Masato Kono, Masato Karayama, Kazuki Furuhashi, Noriyuki Enomoto, Tomoyuki Fujisawa, Naoki Inui, Yutaro Nakamura, Takafumi Suda
• Journal: PloS one (PLoS One) Vol. 13 Issue 6 Pg. e0199659 ( 2018) ISSN: 1932-6203 [Electronic] United States
• PMID: 29928060 (Publication Type: Journal Article)

Chemical References

• Antibodies, Antineutrophil Cytoplasmic
• Peroxidase

Topics

• Aged
• Antibodies, Antineutrophil Cytoplasmic (blood)
• Disease Progression
• Female
• Follow-Up Studies
• Humans
• Idiopathic Interstitial Pneumonias (blood, complications, epidemiology)
• Incidence
• Male
• Microscopic Polyangiitis (blood, complications, epidemiology)
• Middle Aged
• Peroxidase (blood)
• Retrospective Studies
• Risk Factors