Antiperinuclear factor is as sensitive as (0.75 to 0.80) and more specific than (0.94 to 0.97) rheumatoid factor for the diagnosis of rheumatoid arthritis. Although three groups found similar performance characteristics using the assay... more
Antiperinuclear factor is as sensitive as (0.75 to 0.80) and more specific than (0.94 to 0.97) rheumatoid factor for the diagnosis of rheumatoid arthritis. Although three groups found similar performance characteristics using the assay technique described by Youinou, lower sensitivities have also been reported. To clarify these discrepancies, we investigated each parameter of the assay, including storage time of the oral mucosa cells used as the substrate. Even when the slides were frozen, titers fell by one dilution within the first week and by two dilutions within two weeks after sampling. This decline seemed related to storage rather than to freezing: slides kept at 4 degrees C yielded an apparent three-dilution fall in titers after one week and were unevaluable after longer storage times. Successive freeze-thaw cycles did not influence results when the assay was done on the day the cells were sampled and fixed. Titers in sera stored at -25 degrees C remained unchanged or decreased by no more than one dilution during the first 18 months but declined thereafter. These data emphasize the need for performing the assay on the same day or, at the latest, on the day after fixation of the slides. That this precaution was taken should be specified in the "Methods" section of articles on antiperinuclear factor detection.
Research Interests:
To determine the prevalence of antineutrophil cytoplasmic antibodies (ANCA) in patients with active giant cell arteritis (GCA). 23 patients with GCA were selected according to ACR 1990 criteria. Sera were harvested in all patients at an... more
To determine the prevalence of antineutrophil cytoplasmic antibodies (ANCA) in patients with active giant cell arteritis (GCA). 23 patients with GCA were selected according to ACR 1990 criteria. Sera were harvested in all patients at an active stage of the disease and during followup (1 to 3 sera/patient for a total of 50 sera). ANCA positivity was searched for by indirect immunofluorescence (IIF) and enzyme linked immunosorbent assay (ELISA) using a neutrophil extract, and antigen specificity was determined by proteinase 3 (PR3), lactoferrin (LF) and myeloperoxidase (MPO) ELISA: Only 1/23 patients exhibited reactivity in IgG ANCA ELISA and IIF, with borderline anti-MPO reactivity in ELISA which was not inhibited by preincubation with MPO in the liquid phase, and no reactivity in Western blot analysis. Specificity could not be demonstrated in another patient who had positive IgG ANCA ELISA but negative ANCA IIF and negative antigen specific ELISA: All other patients were ANCA negative. As our patients with GCA did not exhibit typical ANCA when validated antigen specific assays were used, careful laboratory controls and clinical evaluation would seem essential in cases of apparent ANCA positivity.
Research Interests:
The vasculitic lesions observed in Wegener's granulomatosis may be partly the consequence of proteases released following activation of neutrophils by ANCA. The activity of these proteases, including proteinase 3 (PR3) and... more
The vasculitic lesions observed in Wegener's granulomatosis may be partly the consequence of proteases released following activation of neutrophils by ANCA. The activity of these proteases, including proteinase 3 (PR3) and elastase, is normally closely restricted to the inflammation site by a large excess of circulating alpha-1-antitrypsin (alpha1AT). Patients with ANCA-positive systemic vasculitis may exhibit a protease/antiprotease imbalance either genetically determined in the rare patients with deficient alpha1AT phenotypes, or more often acquired through both alpha1AT inactivation in various pathological conditions and possible inhibition of PR3/alpha1AT complexation by anti-PR3 ANCA. This imbalance may at least contribute to disease spreading or aggravation.
Research Interests:
Research Interests:
ABSTRACT
Research Interests:
Research Interests:
Autoimmune neutropenias (AIN) are classically divided into primary AIN and secondary AIN. The latter are associated with autoimmune disorders, hematologic malignancies, primary immune deficiencies, drug exposure or infections. In this... more
Autoimmune neutropenias (AIN) are classically divided into primary AIN and secondary AIN. The latter are associated with autoimmune disorders, hematologic malignancies, primary immune deficiencies, drug exposure or infections. In this review we will focus on the major aetiologies of AIN, their differential diagnosis, the various methods in biological diagnosis, and the treatment.
Research Interests:
We report the case of a 5-years old child referred to the pediatric clinic due to a prolonged history of recurrent otitis. Initial immunologic investigation was normal but a severe C3 complement deficiency was detected by the absence of... more
We report the case of a 5-years old child referred to the pediatric clinic due to a prolonged history of recurrent otitis. Initial immunologic investigation was normal but a severe C3 complement deficiency was detected by the absence of beta 2-globulin protein fraction using serum protein capillary electrophoresis. C3 was not detected in serum and total complement haemolytic activity was decreased. His mother and father had half of the C3 normal plasma level and a heterozygous mutation of the C3 gene. The diagnosis of hereditary deficiency of the third complement component (C3) with compound heterozygous mutation of the gene was made. This defect in complement protein C3, described to date in only 20 families in the world, is associated with repeated infections. The child is treated with oracillin with relatively good control of symptoms.
Research Interests:
Research Interests:
The vasculitic lesions observed in Wegener's granulomatosis may be partly the consequence of proteases released following activation of neutrophils by ANCA. The activity of these proteases, including proteinase 3 (PR3) and elastase,... more
The vasculitic lesions observed in Wegener's granulomatosis may be partly the consequence of proteases released following activation of neutrophils by ANCA. The activity of these proteases, including proteinase 3 (PR3) and elastase, is normally closely restricted to the inflammation site by a large excess of circulating alpha-1-antitrypsin (alpha1AT). Patients with ANCA-positive systemic vasculitis may exhibit a protease/antiprotease imbalance either genetically determined in the rare patients with deficient alpha1AT phenotypes, or more often acquired through both alpha1AT inactivation in various pathological conditions and possible inhibition of PR3/alpha1AT complexation by anti-PR3 ANCA. This imbalance may at least contribute to disease spreading or aggravation.
Research Interests:
Research Interests:
ABSTRACT Severe combined immunodeficiency (SCID) is a genetic disorder characterized by a profound deficit of adaptive immunity marked by the absence of T-lymphocytes. Affected children are asymptomatic at birth but die of infections... more
ABSTRACT Severe combined immunodeficiency (SCID) is a genetic disorder characterized by a profound deficit of adaptive immunity marked by the absence of T-lymphocytes. Affected children are asymptomatic at birth but die of infections during the first year of life if they are not diagnosed and managed and are very vulnerable to secondary infections after injection of live vaccines. Hematopoietic stem cell transplantation or gene therapy can replace the faulty immune system and cure these children. Data published in the literature show that the survival of children with SCID and diagnosed before the age of three months is significantly higher than the survival of children diagnosed later. Early diagnosis of SCID would permit the rapid treatment of newborn carriers of the disease before the onset of severe infectious complications, improve survival and quality of life and decrease the side effects and cost of treatment. These data raise the question of the feasibility of generalized neonatal screening for SCID. A biological test called T-cell receptor excision circle (TREC) quantification may be performed using Guthrie cards that are already routinely collected from all infants for other screening tests. This method is highly sensitive and specific. The prospective study that we propose (DEPISTREC trial) aims to study the feasibility of generalized neonatal screening for SCID in France, its clinical and health economic utility and cost-effectiveness ratio. It will seek to show that generalized neonatal screening for SCID is feasible and acceptable to the population.
Because of several side effects, the corticosteroid usage has been minimized in kidney transplantation. The increased acute rejection episodes associated with their withdrawal may counterbalance with induction treatment using polyclonal... more
Because of several side effects, the corticosteroid usage has been minimized in kidney transplantation. The increased acute rejection episodes associated with their withdrawal may counterbalance with induction treatment using polyclonal antilymphocyte globulin (ALG). The effects of ALG on blood cell phenotype have already been the subject of several reports. However, to date, no data are available concerning the comparison of blood phenotype when ALG is given with or without steroids and no gene profiling study has been performed. We report here on a longitudinal blood cell analysis of a selected cohort of kidney recipients enrolled in a randomized study of steroid avoidance or withdrawal (during 6 months) during ALG induction. In the two groups, ALG quickly and massively depleted all the T cells and natural killer cells, but not B cells. Interestingly, the lymphopenia-driven homeostatic proliferation of CD4 and CD8T cells strongly differed with persistent low CD4 (including CD25CD4) T-cell counts. Effector memory CD8T cells reappeared rapidly. ALG induced apoptosis-associated molecules and increased myeloid cell genes. However, few genes were found differentially expressed with a low fold ratio between the two groups during and at distance of corticotherapy. Thus initial steroid avoidance or withdrawal associated with ALG induction has a weak influence on phenotype and transcriptional pattern of blood leukocytes. In contrast, ALG therapy induces an early and strong depletion of all T-cell subsets with contrasted long-lasting homeostatic regulation.
Research Interests:
Research Interests:
Research Interests: Rheumatology, Immunology, Humans, Autoimmune Disease, Systemic Lupus Erythematosus, and 19 moreFemale, P-glycoprotein, Glycoproteins, Primary Antiphospholipid Syndrome, Antiphospholipid antibodies, Clinical Sciences, Adult, Public health systems and services research, Clinical Data, Biological markers, Sensitivity and Specificity, Healthy Subjects, Enzyme Linked Immunosorbent Assay, Predictive value of tests, Positive predictive value, Immunoglobulin, Autoantibodies, immunoglobulin G, and Lupus Anticoagulant(Female, P-glycoprotein, Glycoproteins, Primary Antiphospholipid Syndrome, Antiphospholipid antibodies, Clinical Sciences, Adult, Public health systems and services research, Clinical Data, Biological markers, Sensitivity and Specificity, Healthy Subjects, Enzyme Linked Immunosorbent Assay, Predictive value of tests, Positive predictive value, Immunoglobulin, Autoantibodies, immunoglobulin G, and Lupus Anticoagulant)
(Female, P-glycoprotein, Glycoproteins, Primary Antiphospholipid Syndrome, Antiphospholipid antibodies, Clinical Sciences, Adult, Public health systems and services research, Clinical Data, Biological markers, Sensitivity and Specificity, Healthy Subjects, Enzyme Linked Immunosorbent Assay, Predictive value of tests, Positive predictive value, Immunoglobulin, Autoantibodies, immunoglobulin G, and Lupus Anticoagulant)
Research Interests:
Research Interests:
Research Interests:
Research Interests:
This study aimed to evaluate, improve and compare the performances of two anti-double-stranded DNA (dsDNA) detection kits, differing by their affinity, in discriminating between active and non-active systemic lupus erythematosus (SLE).... more
This study aimed to evaluate, improve and compare the performances of two anti-double-stranded DNA (dsDNA) detection kits, differing by their affinity, in discriminating between active and non-active systemic lupus erythematosus (SLE). Eighty-two anti-nuclear antibody positive sera (45 patients) were tested by two anti-dsDNA commercial quantitative assays (Fidis™, Farrzyme™). All the patients fulfilled at least four of the revised American College of Rheumatology criteria. SLE disease activity was assessed using a modified SLEDAI to remove anti-dsDNA descriptors. When using the manufacturers' cut-offs, no difference in the frequency of positive results was found with respect to disease activity, with Fidis™. On the contrary, with Farrzyme™, a significantly higher frequency of positive sera was found in active SLE patients. Nonetheless, poor performances were observed for both tests. With thresholds defined by ROC methodology, 212IU/mL for Fidis™ (Se: 83.9%, Sp: 86.3%), and 68.8IU/mL for Farrzyme (Se: 71.0%, Sp: 96.1%), a great improvement of the accuracy of the two methods was observed. Moreover, the better specificity and pLR, obtained after optimization of the Farrzyme™ test, could also be obtained with the Fidis™ assay by using a higher threshold than that obtained after optimization of the test. We concluded that when using manufacturers' cut-offs, the two assays appeared to be of poor clinical usefulness in the determination of disease activity. A great improvement was observed using higher thresholds. Moreover, a good concordance could be observed between the two assays (κ=0.764).
Research Interests:
ANCA are autoantibodies directed against polymorphonuclear cell antigens, mainly proteinase 3 (PR3) and myeloperoxidase (MPO), which are implicated in the pathogenesis of small-vessel necrotizing vasculitis. Alpha1-antitrypsin is the main... more
ANCA are autoantibodies directed against polymorphonuclear cell antigens, mainly proteinase 3 (PR3) and myeloperoxidase (MPO), which are implicated in the pathogenesis of small-vessel necrotizing vasculitis. Alpha1-antitrypsin is the main inhibitor of neutral serine proteinase [i.e. human leukocyte elastase (HLE) and PR3] present in PMN alpha-granules (alphaGr). An association first reported by us between PR3 ANCA and the deficient PiZZ phenotype in ANCA-positive systemic vasculitis, now widely confirmed by others, led us to study the incidence and specificity of ANCA among PiZZ subjects. We tested a population of 191 PiZZ (273 sera) for ANCA activity versus 272 PiMM matched control subjects using alphaGr or antigen-specific ELISA [PR3, HLE, MPO, lactoferin (LF) and bactericidal/ permeability increasing protein (BPI)]. The incidence of antibodies directed against alphaGr and HLE but not PR3, MPO, LF or BPI was increased in the PiZZ as compared to the PiMM group (Fisher probability respectively P < 0.0001 and P < 0.05). ANCA not directed against classical antigens (MPO and PR3) may be found in PiZZ patients. However, these patients do not develop systemic vasculitis features. Therefore, alpha1-antitrypsin deficiency is not sufficient to induce ANCA positive vasculitides, and may only act as a second hit amplifying factor.
Research Interests:
Research Interests: Sequence Analysis, Western blotting, Peroxidase, Cell line, Humans, and 14 moreKidney, Vasculitis, Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis, Clinical Sciences, Histones, Fluorescent Antibody Technique, Western blot, Biological markers, Amino Acid Sequence, Immune Complex, Enzyme Linked Immunosorbent Assay, Myeloperoxidase, Autoantibodies, and Molecular Sequence Data(Kidney, Vasculitis, Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis, Clinical Sciences, Histones, Fluorescent Antibody Technique, Western blot, Biological markers, Amino Acid Sequence, Immune Complex, Enzyme Linked Immunosorbent Assay, Myeloperoxidase, Autoantibodies, and Molecular Sequence Data)
(Kidney, Vasculitis, Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis, Clinical Sciences, Histones, Fluorescent Antibody Technique, Western blot, Biological markers, Amino Acid Sequence, Immune Complex, Enzyme Linked Immunosorbent Assay, Myeloperoxidase, Autoantibodies, and Molecular Sequence Data)
Research Interests:
Research Interests:
Three sets of experiments were performed to investigate the quality of myeloperoxidase (MPO) preparations and anti-MPO reagents. In the first experiment, two groups of three and four mice were immunized with commercially purified MPO... more
Three sets of experiments were performed to investigate the quality of myeloperoxidase (MPO) preparations and anti-MPO reagents. In the first experiment, two groups of three and four mice were immunized with commercially purified MPO (Calbiochem). Immunization was performed in PBS in the first group and in acetate buffer in the second. From the first group, five monoclonals were raised, and their specificities examined by ELISA and immunoblotting. Surprisingly, these antibodies reacted with lactoferrin (LF) and not MPO. In the second group, 13 monoclonals were raised; six of these reacted with MPO and seven reacted with LF. In a second set of experiments, MPO and LF reactivity were tested in different buffer conditions in the ELISA procedure. Slight variations in the detection of contaminating LF were found. In a third experiment, polyclonal reagents directed against MPO and LF were tested in MPO immunoblotting studies. A polyclonal anti-MPO reagent reacted not only with MPO but also with contaminating material including LF. The anti-MPO polyclonal reagent also reacted with LF on immunoblotting. We conclude that: (i) caution should be exercised when defining anti-neutrophil cytoplasm specificities of human sera and monoclonals by ELISA, (ii) the low concentration of contaminating LF in the commercially purified reference MPO preparation should be taken into consideration since it appears to have high immunoreactivity, (iii) changes in MPO immunoreactivity may occur under different buffer and pH conditions.
Research Interests:
Research Interests: Immunology, Kinetics, Autoimmunity, Rheumatoid Arthritis, Western blotting, and 13 moreHumans, Systemic Lupus Erythematosus, Ulcerative colitis, Monoclonal Antibodies, Iron, Endothelial cell, ANCA, Monoclonal Antibody, Clinical Presentation, Epitopes, Enzyme Linked Immunosorbent Assay, Microscopic Polyangiitis Market, and Autoantibodies
Alpha1-antitrypsin (alpha1-AT) is encoded by a highly polymorphic gene with over 75 codominantly expressed alleles at the protease inhibitor (Pi) locus classified as normal, deficient, dysfunctional or null. The aim of this study was to... more
Alpha1-antitrypsin (alpha1-AT) is encoded by a highly polymorphic gene with over 75 codominantly expressed alleles at the protease inhibitor (Pi) locus classified as normal, deficient, dysfunctional or null. The aim of this study was to determine in patients with inflammatory bowel disease: (i) the prevalence of anti-neutrophil cytoplasmic auto-antibodies (ANCA) and their antigen specificities; (ii) alpha1-AT Pi phenotypes; and (iii) possible associations between ANCA, disease activity and deficient alpha1-AT alleles. Study of 95 consecutive patients with ulcerative colitis (UC) and 63 patients with Crohn's disease (CD). Diagnosis and disease activity were determined by clinical, endoscopic and histological criteria. ANCA by indirect immunofluorescence (IIF) and Pi phenotyping by isoelectric focusing were performed for all patients. Positive IIF sera were tested in antigen-specific enzyme-linked immunosorbent assay: proteinase 3 (PR3), myeloperoxidase (MPO), lactoferrin (LF), lysozyme, human leucocyte elastase (HLE), cathepsin G and bactericidal/permeability increasing protein (BPI). Sixty-one patients with UC (64.2%) and only 11 with CD (17.5%) had ANCA (P < 0.001). Antigen specificities were PR3 (7/61), MPO (3/61), LF (6/61), HLE (1/63) and BPI (10/61) in UC, and PR3 (2/11) and BPI (2/11) in CD. Three PiZ alleles were found, matching the prevalence in the normal French control population. No relationship was found between the presence of ANCA, antibody specificity, disease activity and deficient alpha1-AT alleles. ANCA are more frequent in UC than CD and do not correlate with disease activity. ANCA and protease/antiprotease imbalance do not appear to modulate the clinical course of inflammatory bowel disease.
Research Interests: Immunology, Molecular Biology, Comparative Study, Inflammatory Bowel Disease, Humans, and 11 moreUlcerative colitis, Phenotype, Clinical Sciences, Association, Prevalence, Enzyme Linked Immunosorbent Assay, Crohn Disease, Antigen, Alpha-1 Antitrypsin, Inflammatory Bowel Diseases, and Severity of Illness Index
We studied the heterogeneity of cytoplasmic islet-cell antibodies for cross-reaction with mouse pancreas in 31 recent-onset Type 1 (insulin-dependent) diabetic patients and 31 first-degree relatives with islet-cell autoantibodies detected... more
We studied the heterogeneity of cytoplasmic islet-cell antibodies for cross-reaction with mouse pancreas in 31 recent-onset Type 1 (insulin-dependent) diabetic patients and 31 first-degree relatives with islet-cell autoantibodies detected on human pancreas. Only six Type 1 diabetic patients displayed islet-cell antibodies binding to human pancreas but not to mouse pancreas. Among 15 first-degree relatives displaying such antibodies which did not react with mouse pancreas, including one identical twin and one subject with polyglandular autoimmunity, none developed diabetes or even lost acute insulin response to intravenous glucose after 5 years of follow-up. By contrast, 14 of 20 (70%) of the Type 1 diabetic patients with islet-cell antibodies detected on human pancreas, and five first-degree relatives who progressed to a loss of acute insulin response to glucose and then to either Type 1 diabetes or glucose intolerance, also displayed antibodies reactive with mouse islets. Surprisingly, islet-cell antibodies were detectable on mouse pancreas but not on human pancreas in four Type 1 diabetic patients and in one relative who progressed to diabetes. In the five relatives who progressed to metabolic abnormalities, islet-cell antibody titres on mouse pancreas, quantified by the fluorescence intensity per islet at each serum dilution, progressively increased concomitantly with the loss of acute insulin response to glucose, whereas islet-cell antibody titres on human pancreas remained stable. The usefulness of such quantification was also validated by the fact that antibody titres on mouse pancreas were decreased after 3 months (p < 0.01) in recent-onset Type 1 diabetic patients, while titres on human pancreas were not.(ABSTRACT TRUNCATED AT 250 WORDS)
Research Interests: Humans, Insulin, Mice, Female, Animals, and 13 moreMale, Follow-up studies, Clinical Sciences, Fluorescent Antibody Technique, Adult, Public health systems and services research, Time Factors, Nuclear Family, Glucose Tolerance Test, Type 2 Diabetes Mellitus, Reference Values, Autoantibodies, and islets of Langerhans
Research Interests:
We tested whether rat and human MPO have similar antigenic determinants using 36 human MPO-ANCA positive sera, one mouse anti-rat MPO and four mouse anti-human MPO monoclonal reagents. Purified rat and human MPO were used in ELISA, with... more
We tested whether rat and human MPO have similar antigenic determinants using 36 human MPO-ANCA positive sera, one mouse anti-rat MPO and four mouse anti-human MPO monoclonal reagents. Purified rat and human MPO were used in ELISA, with or without crossinhibition by preincubation with human MPO or irrelevant antigen in the liquid phase. Only one human MPO ANCA positive serum exhibited significant binding in rat MPO ELISA. This binding was poorly inhibited by preincubation with human MPO in the liquid phase, but was conserved after adsorption of non specific anti-rat activity in a chromatography column. Three mouse anti-human MPO IgG monoclonal antibodies did not recognize rat MPO. Only one mouse anti-human MPO IgA monoclonal antibody bound to rat MPO. This binding was poorly inhibited by preincubation with human MPO (35% at 2 micro g/ml). Conversely, the mouse anti-rat MPO monoclonal did not bind human MPO. We have concluded that: (1) Most human MPO-ANCA recognize antigenic determinants on human MPO which are absent on rat MPO. Therefore, human auto-antibodies bind to epitopes which recently appeared after species evolution; (2) Inversely, the mouse anti-rat MPO monoclonal do not bind human MPO. Therefore, rat MPO epitopes have been altered during species evolution; (3) Mice injected with human MPO preferentially develop antibodies against xeno-epitopes which are not present in rodents. Therefore, human MPO may not be the best antigen to raise ANCA in animal models and (4) A comparison of the amino acid sequences of rat and human MPO may help elucidate the major antigenic epitopes.
Research Interests:
Myeloperoxidase (MPO) is one of the main antigen targets of anti-neutrophil cytoplasmic antibodies (ANCA) in systemic vasculitides. It has been suggested that anti-MPO antibodies may recognize a single epitope on recombinant MPO. If... more
Myeloperoxidase (MPO) is one of the main antigen targets of anti-neutrophil cytoplasmic antibodies (ANCA) in systemic vasculitides. It has been suggested that anti-MPO antibodies may recognize a single epitope on recombinant MPO. If confirmed on native MPO, this might allow specific therapeutic intervention with anti-idiotypic MoAbs to prevent antibody antigen interaction which is thought to cause activation of neutrophils and vasculitis. We searched for restriction in the epitope recognition profile in 50 patients with anti-MPO autoantibodies, using both native and recombinant MPO. Mouse monoclonals were purified and tested in competition assays. At least four epitopes were identified on native MPO using these monoclonals and only two were conserved on recombinant MPO. We found that human MPO autoantibody response was not restricted to a single epitope on native MPO, as all sera tested did not show the same profile in competitive studies with monoclonals. Furthermore, 30% of human anti-native MPO sera failed to recognize rMPO.
Research Interests:
Research Interests:
The american college of rheumatology (ACR) proposed in 1990 revised clinical criteria for systemic vasculitis classification to define homogeneous group of patients for clinical trials. However, microscopic polyarteritis (MPA) was not... more
The american college of rheumatology (ACR) proposed in 1990 revised clinical criteria for systemic vasculitis classification to define homogeneous group of patients for clinical trials. However, microscopic polyarteritis (MPA) was not clearly identified from polyarteritis nodosa (PAN). Since anti-neutrophil cytoplasm antibodies (ANCA) are markers of disease activity of small vessel vasculitides including MPA, we tested the clinical significance of ANCA in 24 patients with PAN according to the ACR 1990 criteria. Two of 24 patients had ANCA, as defined by indirect immunofluorescence on normal human neutrophils, antigen-specific ELISA and Western blot analysis. However, they exhibited histologically proven small vessel but not medium vessel vasculitis. Furthermore, they had neither artery microaneurysms nor large organ injury consequent upon large vessel occlusion. Although they satisfied ACR criteria for PAN, they probably were misclassified and should be considered as MPA. We conclude that: (i) ANCA are not found in patients with classical PAN in the absence of MPA features; (ii) caution should be exercised when defining PAN according to the ACR 1990 criteria; (iii) ANCA may help systemic vasculitis classification.
Research Interests:
Research Interests:
Research Interests: Kidney transplantation, Renal transplantation, Humans, Renal failure, End Stage Renal Failure, and 17 moreMale, American, Recurrence, Clinical Sciences, Cadaver, Aged, Kidney Transplant, Western blot, Disease Activity, IgA nephropathy, Enzyme Linked Immunosorbent Assay, Myeloperoxidase, Microscopic Polyangiitis Market, immunoglobulin G, Nephrotic syndrome, Postoperative Complications, and Immunoglobulin A(Male, American, Recurrence, Clinical Sciences, Cadaver, Aged, Kidney Transplant, Western blot, Disease Activity, IgA nephropathy, Enzyme Linked Immunosorbent Assay, Myeloperoxidase, Microscopic Polyangiitis Market, immunoglobulin G, Nephrotic syndrome, Postoperative Complications, and Immunoglobulin A)
(Male, American, Recurrence, Clinical Sciences, Cadaver, Aged, Kidney Transplant, Western blot, Disease Activity, IgA nephropathy, Enzyme Linked Immunosorbent Assay, Myeloperoxidase, Microscopic Polyangiitis Market, immunoglobulin G, Nephrotic syndrome, Postoperative Complications, and Immunoglobulin A)