Search

The diagnostic value of c-ANCA as a specific marker of systemic vasculitis (particularly Wegener's granulomatosis) is well established. The prognostic value of c-ANCA for determining disease activity is controversial. We have prospectively studied in ten patients with systemic vasculitis over a mean period of 34 months (extreme 2-61 months). All patients had c-ANCA at the moment of the diagnosis: four patients had high titer of c-ANCA all over the period study; three clinical and biological exacerbations of the disease was observed without variation of the c-ANCA titer. In four patients c-ANCA disappeared within 6 months after the beginning of the treatment correlated with disease activity. Sometimes a rise of c-ANCA titer was observed with or without disease activity. In one case c-ANCA titer had a serrated evolution. The sensitivity and the specificity of the c-ANCA for disease activity in the ten studied patients were respectively 1 and 0.28. In patients with systemic vasculitis and c-ANCA at the time of the diagnosis, variation in c-ANCA titer alone is of limited prognostic value for predicting disease course.

c-ANCA have been described as sensitive and specific markers for active Wegener's granulomatosis. We studied 9 patients with systemic vasculitis and c-ANCA over a mean period of 36 months. c-ANCA titer alone is of limited pronostic value for predicting disease activity and should not be the sole criteria for modifying therapy.

A total of 116 sera of patients suffering from South American mucocutaneous leishmaniasis were analysed using the RAST (L. braziliensis-specific) and RIST techniques. Results of total and specific IgE levels were correlated with different clinical stages of the disease. The level of total and specific IgE appeared to be higher among patients with cutaneous ulcers than among those presenting mucocutaneous lesions, i.e. espundia. Furthermore, non-treated patients presented higher concentrations of total and specific IgE than did treated ones.

We show here an automated (50 samples/h) assay for serum IgG4 having a throughput time of 40 min per sample and a sensitivity of 10 μg/ml. The assay procedure is based on the inhibition by sample of the agglutination reaction between monoclonal anti-IgG4 antibodies and latex particles to which IgG4 myeloma protein has been coupled. Assay reliability was ascertained by testing for linearity, analytical recovery (96.4%), interassay precision (≤8%), specificity and correlation between the results obtained with monoclonal and polyclonal anti-IgG4 antibodies (n = 84; rs = 0.97). Application of the assay to sera from various groups of patients indicated significantly (p < 0.00005) higher geometrical means (Gx) in patients suffering from atopy (n = 87; Gx = 617 μg/ml), atopic dermatitis (n = 28; Gx = 1,043 μg/ml), filariasis with Onchocerca volvulus (n = 48; Gx = 1,681 μg/ml) and Brugia malayi(n = 20; Gx = 1,078 μg/ml) as compared to nonatopic subjects (n = 103; Gx = 302 μg/ml) and randomized paired maternal/cord sera (n = 41; Gx = 276 and 296 μg/ml, respectively). IgG4 in the paired maternal/cord sera correlated (r = 0.98; p μg/ml) was more common among women. The results suggest that IgG4 and IgE responses are somehow closely related in atopic and parasite-infested patients at the physiological, pathogenic or genetic level.