Limited Prognostic Value of Changes in Antineutrophil Cytoplasmic Antibody Titers in Patients with Wegener’s Granulomatosis
One hundred and six patients with Wegener’s granulomatosis (WG) were studied for the presence of antineutrophil cytoplasmic antibodies (ANCA). In 53 patients serial ANCA determinations were obtained. C-ANCA positivity was a sensitive (88%) marker of active WG. However, changes in serial titers were temporally concordant with a change in disease status in only 55% of patients. Furthermore, a rise in c-ANCA titer preceded clinical exacerbation of disease in only 24% of patients who had been in remission or had low grade, smoldering disease. A rise in c-ANCA titer alone should not be considered a priori evidence of impending relapse, and does not justify modification of immunosuppressive therapy.
KeywordsToxicity Tuberculosis Sedimentation Methotrexate Glucocorticoid
Unable to display preview. Download preview PDF.
- Cohen Tervaert, J.W., Fokko, J., van der Woude, M.D., Fauci, A.S., Ambrus, J.L., Velosa, J., Keane, W.F., Meijer, S., van der Jiessen, M., Hauw, The, T., van der Hem, G.K., Kallenberg, C.G.M., 1989, Association between active Wegener’s granulomatosis and anticytoplasmic antibodies, Arch Intern Med. 149: 2461–2465.Google Scholar
- 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., 1985, Autoantibodies against neutrophils and monocytes: tool for diagnosis and marker of disease activity in Wegener’s granulomatosis, Lancet 1: 425–429.PubMedCrossRefGoogle Scholar