Editorial

New Lung Lesion in Immunocompromised Host-Correct Diagnosis Despite a False Positive ANCA

Authors: Muthiah P. Muthiah, MD, FCCP

Abstract

Pulmonary vasculitides are rare, yet occur frequently enough that the clinician must be adequately aware of their clinical manifestations and laboratory features. Unrecognized, the consequences can be devastating, since untreated patients with vasculitis syndrome can suffer significant morbidity and mortality. More devastating is the scenario where, because of suspected vasculitis, an infection is treated with immunosuppression without the cover of antibiotics, leaving the host open to the devastation of the offending organism due to the lack of protection from the immune system.

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References

1. van der Woude FJ, Daha MR, van Es LA. The current status of neutrophil cytoplasmic antibodies.Clin Exp Immunol 1989;78:143–148.
 
2. Niles JL. Antineutrophil cytoplasmic antibodies in the classification of vasculitis. Annu Rev Med1996;47:303–313.
 
3. Reinhold-Keller E, Beuge N, Latza U, et al. An interdisciplinary approach to the care of patients with Wegener’s granulomatosis: long-term outcome in 155 patients. Arthritis Rheum 2000;43:1021–1032.
 
4. Bligny D, Mahr A, Toumelin PL, et al. Predicting mortality in systemic Wegener’s granulomatosis: a survival analysis based on 93 patients. Arthritis Rheum 2004;51:83–91.
 
5. Van Der Woude FJ. Taking anti-neutrophil cytoplasmic antibody (ANCA) testing beyond the limits.Nephrol Dial Transplant 2002;17:2081–2083.
 
6. Falk RJ, Jennette JC. ANCA are pathogenic: oh yes they are! J Am Soc Nephrol 2002;13:1977–1979.
 
7. van der Woude FJ, Rasmussen N, Labatto S, et al. Autoantibodies against neutrophils and monocytes: tool for diagnosis and marker of disease activity in Wegener’s granulomatosis. Lancet1985;1:425–429.
 
8. Manepalli AN, Rush L. Disseminated histoplasmosis and Wegener’s granulomatosis. South Med J1998;91:1156–1158.
 
9. Ullmer E, Mayr M, Binet I, et al. Granulomatous Pneumocystis carinii pneumonia in Wegener’s granulomatosis. Eur Respir J 2000;15:213–216.
 
10. Sarosi GA, DS. Fungal Diseases of the Lung. Third edition. Lippincott Williams & Wilkins, 2000, p 322.
 
11. Lee AS, Wiesner O, Gillespie DJ, et al. A 70-year-old man with pulmonary infiltrates and a positive antineutrophil cytoplasmic autoantibody test result. Chest 2005;127:1045–1050.
 
12. Vassilopoulos D. Niles JL, Villa-Forte A, et al. Prevalence of antineutrophil cytoplasmic antibodies in patients with various pulmonary diseases or multiorgan dysfunction. Arthritis Rheum 2003;49:151–155.