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Clinical interpretation of antineutrophil cytoplasmic antibodies: parvovirus B19 infection as a pitfall

J Hermann1, U Demel, D Stünzner

  • 1Medical University, Graz, Department of Internal Medicine, Division of Rheumatology, Auenbruggerplatz 15, A-8036 Graz, Austria. josef.hermann@meduni-graz.at

Annals of the Rheumatic Diseases
|October 16, 2004
PubMed
Abstract

Insights

Antibodies against proteinase 3 (PR3-ANCA) and myeloperoxidase (MPO-ANCA) can transiently appear during acute parvovirus B19 infection. Repeated antibody testing is crucial for diagnosing autoimmune conditions in patients with mild symptoms.

Area of Science:

  • Immunology
  • Virology
  • Rheumatology

Background:

  • Anti-neutrophil cytoplasmic antibodies (ANCA), specifically PR3-ANCA and MPO-ANCA, are key diagnostic markers for systemic vasculitis.
  • However, ANCA positivity can also occur transiently during acute viral infections, potentially complicating diagnoses.

Observation:

  • This study investigated the prevalence of ANCA in patients with acute parvovirus B19 infection.
  • Sera from patients with suspected viral infections were analyzed for parvovirus B19, EBV, PR3-ANCA, and MPO-ANCA.

Findings:

  • ANCA were detected in 10% of individuals with acute parvovirus B19 IgM antibodies and in a smaller proportion with EBV IgM antibodies.
  • Among patients with parvovirus B19 and arthritis, PR3-ANCA and MPO-ANCA were observed but resolved within six months.

Implications:

  • Transient PR3-ANCA and MPO-ANCA positivity can occur in acute parvovirus B19 infection and infectious mononucleosis.
  • This underscores the necessity of serial antibody testing in oligosymptomatic patients suspected of systemic autoimmune disease to avoid misdiagnosis.

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