OBJECTIVE: To assess the correlation and prognostic value of antineutrophil cytoplasmic antibody (cANCA) titers with disease activity in patients with Wegener's granulomatosis (WG). METHODS: One hundred six patients with WG had serum ANCA determinations; 72 had serial titers obtained routinely at 1-3-month intervals. One hundred twelve subjects (19 of whom were healthy donors) served as controls. All serum samples were tested for cANCA by an indirect immunofluorescence technique. A prospective analysis of disease activity and cANCA values was performed. Disease activity was assessed according to clinical, laboratory, radiographic, and histopathologic findings. RESULTS: Positivity for cANCA was a sensitive (88%) marker of active WG. However, changes in serial titers temporally correlated with a change in disease status in only 64% of patients. Furthermore, an increase in the cANCA titer preceded clinical exacerbation of disease in only 24% of patients who had been in remission or had low-grade, smoldering disease. CONCLUSION: A rise in cANCA titer alone should not be considered adequate evidence of an impending clinical exacerbation, and therefore does not justify initiating or increasing immunosuppressive therapy.
OBJECTIVE: To assess the correlation and prognostic value of antineutrophil cytoplasmic antibody (cANCA) titers with disease activity in patients with Wegener's granulomatosis (WG). METHODS: One hundred six patients with WG had serum ANCA determinations; 72 had serial titers obtained routinely at 1-3-month intervals. One hundred twelve subjects (19 of whom were healthy donors) served as controls. All serum samples were tested for cANCA by an indirect immunofluorescence technique. A prospective analysis of disease activity and cANCA values was performed. Disease activity was assessed according to clinical, laboratory, radiographic, and histopathologic findings. RESULTS: Positivity for cANCA was a sensitive (88%) marker of active WG. However, changes in serial titers temporally correlated with a change in disease status in only 64% of patients. Furthermore, an increase in the cANCA titer preceded clinical exacerbation of disease in only 24% of patients who had been in remission or had low-grade, smoldering disease. CONCLUSION: A rise in cANCA titer alone should not be considered adequate evidence of an impending clinical exacerbation, and therefore does not justify initiating or increasing immunosuppressive therapy.
Authors: Hans-J Mentzel; Thomas Neumann; Clemens Fitzek; Dieter Sauner; Jürgen R Reichenbach; Werner A Kaiser Journal: AJNR Am J Neuroradiol Date: 2003-01 Impact factor: 3.825
Authors: Gunnar Tomasson; Peter C Grayson; Alfred D Mahr; Michael Lavalley; Peter A Merkel Journal: Rheumatology (Oxford) Date: 2011-10-29 Impact factor: 7.580
Authors: Paul A Monach; Gunnar Tomasson; Ulrich Specks; John H Stone; David Cuthbertson; Jeffrey Krischer; Linna Ding; Fernando C Fervenza; Barri J Fessler; Gary S Hoffman; David Ikle; Cees G M Kallenberg; Carol A Langford; Mark Mueller; Philip Seo; E William St Clair; Robert Spiera; Nadia Tchao; Steven R Ytterberg; Yi-Zhong Gu; Ronald D Snyder; Peter A Merkel Journal: Arthritis Rheum Date: 2011-12