Infective endocarditis with antineutrophil cytoplasmic antibody: report of 13 cases and literature review

Autor: Dong-Ting Yao, Chengde Yang, Huihua Ding, Chun-Mei Ying
Rok vydání: 2013
Předmět:
Male
Bacterial Diseases
Epidemiology
lcsh:Medicine
Kaplan-Meier Estimate
urologic and male genital diseases
immune system diseases
Prevalence
Clinical Epidemiology
lcsh:Science
skin and connective tissue diseases
Multidisciplinary
biology
Endocarditis
Streptococci
Middle Aged
Bacterial Pathogens
Infectious Diseases
Infective endocarditis
Medicine
Female
Antibody
Vasculitis
Research Article
Adult
China
Clinical Research Design
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Enzyme-Linked Immunosorbent Assay
Microbiology
Infectious Disease Epidemiology
Antibodies
Antineutrophil Cytoplasmic
Diagnosis
Differential
Streptococcal Infections
medicine
Humans
cardiovascular diseases
Biology
Anti-neutrophil cytoplasmic antibody
Population Biology
business.industry
lcsh:R
medicine.disease
respiratory tract diseases
Immunology
biology.protein
lcsh:Q
Differential diagnosis
business
Zdroj: PLoS ONE
PLoS ONE, Vol 9, Iss 2, p e89777 (2014)
ISSN: 1932-6203
Popis: OBJECTIVE: Chronic infections tend to induce the production of antineutrophil cytoplasmic antibody (ANCA). Infective endocarditis (IE) has been reported to exhibit positive ANCA tests and to mimic ANCA-associated vasculitis, which may lead to a misdiagnosis and inappropriate treatment. The aim of this study was to clarify whether there is any difference in the clinical features between ANCA-positive IE and ANCA-negative IE. METHODS: A retrospective study was carried out on 39 IE patients whose proteinase 3 (PR3)-ANCA and myeloperoxidase (MPO)-ANCA levels were measured. After dividing the patients into ANCA-positive and ANCA-negative IE, we compared their clinical features. RESULTS: we compared 13 ANCA-positive IE patients with 26 ANCA-negative IE patients. All 13 ANCA-positive IE patients were proteinase-3-ANCA positive. Compared with the ANCA-negative IE group, the prevalence of edema of the lower extremities, the serum lactate dehydrogenase (LDH) level and positive blood cultures rate were higher in ANCA-positive IE group, but there was no significant difference in other clinical features. CONCLUSION: Therefore, if a patient presents with fever, arthralgia, skin rash and is ANCA-positive, appropriate steps should be taken to exclude infection (especially IE) before confirming the diagnosis of ANCA-associated vasculitis and embarking on long-term immunosuppressive therapy.
Databáze: OpenAIRE
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