[Clinical consequence and significance of anti-neutrophil cytoplasmic antibody positivity in anti-glomerular basement membrane disease].

Abstract

INTRODUCTION:

Patients with renopulmonary syndrome who have both anti-neutrophil cytoplasmic and anti-glomerular basement membrane antibodies have been described since 1989.

AIM:

The aim of the authors was to analyse the data of "double positive" patients diagnosed in their department, and compare these with previous studies.

METHOD:

During the last 16 years, 87 anti-neutrophil cytoplasmic antibody positive and 11 anti-glomerular basement membrane antibody positive patients were diagnosed. Four patients with anti-glomerular basement membrane antibodies (36%) had detectable anti-neutrophil cytoplasmic antibodies, 2 patients were positive for anti-myeloperoxidase and 2 patients for anti-proteinase 3.

RESULTS:

In comparison with patients having anti-glomerular basement membrane antibodies, the double-positive patients were characterized by older age (median of 46 vs. 24 years), lack of male dominance (50% vs. 71%), more frequent presence of previous extrarenal symptoms (50% vs. 0%), and lower anti-glomerular basement membrane antibody levels (<100EU/ml: 100% vs. 29%). The double-positive patients had more favourable 1-year survival (100% vs. 71%), despite their older age and similar treatment regimen (immunosuppression 100% in both groups, plasmapheresis in 75% vs. 86%), but 1-year renal survival was not different (25% vs. 14%).

CONCLUSIONS:

In agreement with literature data, about one third of patients with anti-glomerular basement membrane antibodies had detectable anti-neutrophil cytoplasmic antibodies, and the coexistence of the two antibodies may have clinical consequences.

• Authors: Ibolya File, Klára Pucsok, Csilla Trinn, László Ujhelyi, József Balla, János Mátyus
• Journal: Orvosi hetilap (Orv Hetil) Vol. 154 Issue 43 Pg. 1696-701 (Oct 27 2013) ISSN: 0030-6002 [Print] Hungary
• Vernacular Title: Antiglomeruláris bazálmembrán betegségben észlelt antineutrofil citoplazmatikus antitest pozitivitás klinikuma, jelentősége.
• PMID: 24140508 (Publication Type: Comparative Study, English Abstract, Journal Article)

Chemical References

• Antibodies, Antineutrophil Cytoplasmic
• Autoantibodies
• antiglomerular basement membrane antibody

Topics

• Adult
• Age Distribution
• Age Factors
• Aged
• Anti-Glomerular Basement Membrane Disease (immunology)
• Antibodies, Antineutrophil Cytoplasmic (blood)
• Autoantibodies (blood)
• Female
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Sex Distribution
• Sex Factors