Antineutrophil cytoplasmic antibodies (ANCA): current perspectives
The idiopathic systemic vasculitides constitute a group of disorders characterized by more or less widespread inflammation of vessel walls generally without an underlying cause or an associated condition. The idiopathic vasculitides are traditionally grouped according to the size of the vessels involved and the histopathology of the inflammatory process. Such a classification is shown in Table 4.1. A recent modification of this scheme based on a more strict application of histopathological criteria with respect to the size of the vessels involved , is given in Table 4.2. The definitions and classification of the vasculitides demonstrate that histopathological findings are essential for making a diagnosis of a distinct vasculitic disorder. In clinical practice, however, pathognomonic histopathological findings are hard to obtain in most patients suspected of vasculitis, even in cases where multiple biopsies have been performed . For this and other reasons, classification criteria have been designed by the American College of Rheumatologists (ACR) that are mainly based on clinical signs and symptoms . These criteria can be used for the classification of patients who have al.ready have been proved to have vasculitis.
KeywordsArthritis Corticosteroid Titration Serine Vasculitis
Unable to display preview. Download preview PDF.
- 6.Wiik, A. (1989) Delineation for a standard procedure for indirect immunofluorescence detection of ANCA. APMIS, 97 (Suppl. 6), S12–S13.Google Scholar
- 10.Peter, H.H., Metzger, D., Rump, A. and Röther, E. (1993) ANCA in diseases other than systemic vasculitis. Clin. Exp. Immunol., 91 (Suppl. 1), S12–S14.Google Scholar
- 14.Goldschmeding, R., Cohen Tervaert, J.W., van der Schoot, C.E. et al. (1989) ANCA, anti-myeloperoxidase, and anti-elastase: three members of a novel class of autoantibodies against myeloid lysosomal enzymes. APMIS, 97 (S6), 48–9.Google Scholar
- 20.Coremans, I.E.M., Hagen, E.C., Daha, M.R. et al. (1993) Anti-lactoferrin antibodies in patients with Felty’s syndrome. Clin. Exp. Immunol., 93 (Suppl. 1), S33.Google Scholar
- 29.Kallenberg, C.G.M. and Cohen Tervaert, J.W. (1992) Anti-neutrophilic cytoplasmic antibodies: new tools in the diagnosis and follow-up of necrotizing glomerulonephritis, in International Yearbook of Nephrology (eds V.E. Andreucci and L.G. Fine), pp. 313–36.Google Scholar
- 32.Pudifin, D.J., Duursma, J., Gathiram, V. and Jackson, T.F.G.H. (1993) Serum from patients with invasive amoebiasis has anti-neutrophil cytoplasmic antibody activity. Clin. Exp. Immunol., 93 (Suppl. 1), S33.Google Scholar
- 47.Kallenberg, C.G.M., Cohen Tervaert, J.W. and Limburg, P.C. (1991) ELISA for the detection of antibodies against neutrophil cytoplasm antigens, in Techniques in diagnostic pathology, Vol. 2 (eds G.R. Bullock, D. van Velzen, M.J. Warhol and P. Herbrink), Academic Press, London, pp. 43–60.Google Scholar
- 48.Cohen Tervaert, J.W. and Kallenberg, C.G.M. (1993) Neurologic manifestations of systemic vasculitides, in Neurologic aspects of rheumatic diseases. Rheumatic Disease Clinics of North America (ed. K.B. Elkon), Vol. 19, WB Saunders, Philadelphia, pp. 913–40.Google Scholar
- 51.Charles, L.A., Caldas, M.L.R., Falk, R.J. et al. (1991) Antibodies against granule proteins activate neutrophils in vitro. J. Leuk. Biol., 50, 539–46.Google Scholar
- 52.Mulder, A.H.L., Horst, G., Limburg, P.C. and Kallenberg, C.G.M. (1993) Activation of neutrophils by anti-neutrophil cytoplasmic antibodies is FcR-dependent. Clin. Exp. Immunol., 93 (Suppl. 1), S16.Google Scholar
- 54.Dolman, K.M., Stegeman, C.A., van de Wiel, B.A. et al. (1993) Relevance of classic anti-neutrophil cytoplasmic autoantibody (c-ANCA)-mediated inhibition of proteinase 3-α1-antitrypsin complexation to disease activity in Wegener’s Granulomatosis. Clin. Exp. Immunol., 93, 405–10.PubMedCrossRefGoogle Scholar