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ANCA seropositivity in HIV: a serological pitfall
T L Th A Jansen1, D van Houte, T de Vries
1Department of Rheumatology, Leeuwarden Medical Centre, Leeuwarden, Netherlands. T.Jansen@znb.nl
The Netherlands Journal of Medicine
|August 12, 2005
Summary
Cytoplasmic antineutrophilic cytoplasmic antibody (c-ANCA) tests can indicate Wegener's disease. However, a positive c-ANCA result alone may lead to misdiagnosis in pulmonary inflammation cases.
Area of Science:
- Immunology
- Rheumatology
- Pathology
Background:
- Cytoplasmic antineutrophilic cytoplasmic antibody (c-ANCA) is a key serological marker for systemic vasculitis.
- Diagnosis of Wegener's granulomatosis often involves c-ANCA positivity alongside upper airway or renal symptoms, confirmed by biopsy.
Observation:
- Not all patients with pulmonary inflammation and positive c-ANCA have Wegener's disease.
- A 40-year-old male with upper airway symptoms and c-ANCA positivity was initially suspected of having Wegener's disease.
- Further testing showed the patient was negative for proteinase-3 antibodies but positive for myeloperoxidase antibodies.
Findings:
- The case highlights that c-ANCA positivity can occur coincidentally, potentially leading to misdiagnosis.
- Specificity analysis revealed myeloperoxidase antibodies, not proteinase-3 antibodies, were present.
Implications:
- Clinicians should be aware of the potential serological pitfalls of c-ANCA testing.
- Further antibody testing is crucial to avoid misdiagnosing Wegener's disease in ANCA-positive patients with pulmonary symptoms.