Summary
A 39-year-old Ugandan student is described presenting with general malaise, fever and a pulmonary infiltrate. Open lung biopsy showing infarction and positive ANCA lead to a diagnosis of Wegener's granulomatosis and a treatment with immunosuppressive drugs was instituted. Five weeks after admission, however, sputum cultures turned out to be positive for Mycobacterium tuberculosis. The importance of ANCAinterpretation and the possibility of false positive results is discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Fauci, A.S., Haynes, B.F., Katz, P. The spectrum of vasculitis. Clinical, pathologic, immunologic and therapeutic considerations. Ann Intern Med 1978, 89, 660–676.
Van der Woude, F.J., Rasmussen, N., Lobatto, S., Wiik, A., Permin, H., Van Es, L.A., Van der Giessen, M., Van der Hem, G.K., The, T.H. Autoantibodies against neutrophils and monocytes: tool for diagnosis and marker of disease activity in Wegener's granulomatosis. Lancet 1985, 1, 425–429.
Savage, C.O., Winearis, C.G., Jones, S., Marshall, P.D., Lockwood, C.M. Prospective study of radioimmunoassay for antibodies against neutrophil cytoplasm in diagnosis of systemic vasculitis. Lancet 1987, 1, 1389–1393.
Van der Woude, F.J., Hoorntje, S.J., Weening, J.J., Van Overbeek, J.J., Van der Hem, G.K. Renal involvement in Wegener's granulomatosis: report of three unusual cases. Nephron 1982, 32, 185–187.
DeRemee, R.A., Weiland, L.H., McDonald, T.J. Respiratory vasculitis. Mayo Clin Proc 1980, 55, 492–498.
Scully, R.E., Mark, E.J., McNeely, B.U. Case records of the Massachusetts General Hospital, case 43-1981. N Engl J Med 1981, 305, 999–1008.
Fauci, A.S., Haynes, B.F., Katz, P., Wolff, S.M. Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. Ann Intern Med 1983, 98, 76–85.
Gross, W.L., Lüdemann, G., Kiefer, G., Lehmann, H. Anticytoplasmic antibodies in Wegener's granulomatosis. Lancet 1986, 1, 806.
Rasmussen, N., Wiik, A., Hoier-Madsen, M., Borregaard, N., Van der Woude, F. Anti-neutrophil cytoplasm antibodies 1988. Lancet 1988, 1, 706–707.
Andrassi, K., Koderisch, J., Waldherr, R., Rufer, M. Diagnostic significance of anticytoplasmatic antibodies (ACPA/ANCA) in detection of Wegener's granulomatosis and other forms of vasculitis. Nephron 1988, 49, 257–258.
Falk, R.J., Jenette, J.C. Anti-neutrophil cytoplasmic autoantibodies with specificity for myeloperoxidase in patients with systemic vasculitis and idiopathic necrotizing and crescentic glomerulonephritis. N Engl J Med 1988, 318, 1651–1657.
Rasmussen, N., Wiik, A. New perspectives in the diagnosis of Wegener's granulomatosis, 11 Nephrologisches Seminar Heidelberg, 1987, 1–6.
Katzenstein, A.L. Necrotizing granulomas of the lung. Hum Pathol 1980, 11, 596–597.
Harrison, N.K., Knight, R.K. Tuberculosis of the nasopharynx misdiagnosed as Wegener's granulomatosis. Thorax 1986, 41, 219–220.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
DE Clerck, L.S., Van Offel, J.F., Smolders, W.A. et al. Pitfalls with anti-neutrophil cytoplasmic antibodies (ANCA). Clin Rheumatol 8, 512–516 (1989). https://doi.org/10.1007/BF02032106
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02032106