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Negative ANCA in Wegener's granulomatosis
S Carrie1, K B Hughes, M G Watson
1Department of Otolaryngology, Doncaster Royal Infirmary.
The Journal of Laryngology and Otology
|May 1, 1994
Summary
Wegener's granulomatosis can initially present with negative antineutrophil cytoplasmic antibodies (ANCA). Some patients may develop positive ANCA titres as the systemic vasculitis progresses, aiding later diagnosis.
Area of Science:
- Rheumatology
- Immunology
- Internal Medicine
Background:
- Wegener's granulomatosis is a systemic vasculitis with poor prognosis if untreated.
- Antineutrophil cytoplasmic antibodies (ANCA) are key serological markers for early diagnosis and treatment.
- Early and accurate diagnosis is crucial for managing this condition.
Observation:
- Two cases of Wegener's granulomatosis with initial ANCA-negative status are presented.
- Clinical suspicion for Wegener's granulomatosis was high in both patients despite negative ANCA.
- Disease progression was monitored in both ANCA-negative patients.
Findings:
- Both patients initially tested negative for antineutrophil cytoplasmic antibodies (ANCA).
- Over time, both patients developed positive ANCA titres.
- The development of positive ANCA correlated with disease progression.
Implications:
- Initial ANCA-negative results do not exclude Wegener's granulomatosis.
- Serial ANCA testing may be valuable in suspected cases with initial negative results.
- This highlights the dynamic nature of ANCA serology in systemic vasculitis.