1. What is the meaning of ANCA positivity in IgG4-related disease?
- Author
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Martín-Nares E and Hernandez-Molina G
- Subjects
- Adult, Aged, Aortic Diseases immunology, Biliary Tract Diseases immunology, Case-Control Studies, Female, Humans, Lacrimal Apparatus Diseases immunology, Liver Diseases immunology, Male, Microscopy, Fluorescence, Middle Aged, Myeloblastin metabolism, Pancreatic Diseases immunology, Peroxidase metabolism, Retroperitoneal Space, Retrospective Studies, Salivary Gland Diseases immunology, Antibodies, Antineutrophil Cytoplasmic immunology, Immunoglobulin G4-Related Disease immunology, Kidney Diseases immunology, Lymph Nodes immunology, Myeloblastin immunology, Peroxidase immunology
- Abstract
Objectives: To evaluate the prevalence and meaning of antineutrophil cytoplasmic antibodies (ANCA) positivity in a cohort of IgG4-related disease (IgG4-RD)., Methods: We identified patients with ANCA determination from a retrospective cohort of 69 patients with IgG4-RD. ANCA were measured by indirect immunofluorescence microscopy (IIF) and/or proteinase 3 (PR3)-ANCA and MPO-ANCA by ELISA. IIF patterns were classified as perinuclear (P-ANCA), cytoplasmic (C-ANCA) and atypical (X-ANCA). We compared the ANCA-positive vs the ANCA-negative IgG4-RD group., Results: Out of 69 patients, 31 IgG4-RD patients had an ANCA determination. Four patients with concomitant systemic autoimmune diseases were excluded. We found positive ANCA by IIF in 14 (56%) of 25 patients tested. The most common IIF pattern was C-ANCA in eight (57.1%), followed by dual C-ANCA/X-ANCA in four (28.6%) and P-ANCA and dual C-ANCA/P-ANCA in one each (7.1%). Of the 20 patients with ANCA determination by both IIF and ELISA, four have positive ANCA by ELISA (three for MPO-ANCA and one for PR3-ANCA). Of the two patients with only ELISA determination, one was positive for MPO-ANCA. The prevalence of ANCA positivity by ELISA was 22.7% (5 out of 22 patients). ANCA was more frequent in the Mikulizc/systemic phenotype (42.9%) compared with other phenotypes (P = 0.04). ANCA-positive IgG4-RD patients had more frequently lymph node and kidney involvement, high IgG1 levels and erythrocyte sedimentation rate, and positive antinuclear antibodies., Conclusion: ANCA are found in a significant number of patients with IgG4-RD and differed from the ANCA-negative group in terms of clinical and serological features., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2021
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