ANCA testi pozitif olan hastaların otoimmünite ve vaskülit açısından klinik olarak incelenmesi

Abstract

Amaç: Antinötrofil sitoplazmik antikorlar (ANCA), nötrofil ve monositlerde görülen lizozomal granülleri spesifik olarak hedef alan otoantikorlardır. Çalışmanın amacı, ANCA testi pozitif olan hastaları otoimmün bozukluklar ve vaskülit açısından araştırmaktır. Gereç ve Yöntemler: Bu 4 yıllık retrospektif kohort araştırmasında üçüncü basamak bir hastaneye gönderilen 9.480 serum örneği analiz edilmiştir. Başlangıç değerlendirmesi, vaskülit ve diğer otoimmün ve otoimmün olmayan hastalıkları olan 218 uygun ANCA-pozitif hastayı içeriyordu. Bulgular: ANCA ilişkili vaskülit (AAV) bireylerine göre diğer iki grup daha az pulmoner, renal, kulak burun boğaz (KBB), oftalmik ve nörolojik tutuluma sahiptir. AAV ve otoimmün hastalık hastalarında eklem ve cilt tutulumu otoimmün olmayan hastalık hastalarına göre daha yüksektir. Hipertansiyon ve kronik böbrek yetmezliği AAV ve otoimmün olmayan bireylerde otoimmün olanlara göre daha yaygındır. Kronik obstrüktif hastalık (KOAH) ve proteinüri AAV hastalarında otoimmün hastalık hastalarına göre daha yüksektir. AAV hastalarında diğer ikisine göre daha fazla hematüri vardır. Otoimmün olmayan hastalıkta miyelopereoksidaz (MPO) titresi ve eritrosit sedimentasyon hızı (ESR) otoimmün hastalığa göre daha yüksektir. Yüksek proteinaz 3 (PR3) titreleri AAV ve otoimmün hastalıklarla ilişkilidir. AAV hastalarında C reaktif protein (CRP) ve kompleman 3 (C3) diğer iki gruba göre daha yüksektir. AAV'de C4 ve romatoid faktör (RF) otoimmün olmayan hastalığa göre daha yüksektir. Otoimmün hastalığı olanların başlangıç glomerüler filtrasyon hızı (GFR) diğer iki gruptan daha yüksektir. Sonuç: ANCA'nın birçok AAV benzeri hastalıkta pozitif olabileceği sonucuna vardık. Üçüncü basamak bir hastanede ANCA titreleri, özellikle PR3 ile AAV klinik tanısı arasında güçlü bir korelasyon bulunmuştur. ANCA titresi ve organ sistemi kapsamı klinik AAV tanı göstergeleri olabilir.

Keywords

• antinötrofil sitoplazmik antikor
• miyelopreoksidaz
• proteinaz 3
• otoimmün
• vaskülit

Clinical investigation of patients with positive antineutrophil cytoplasmic antibodies (ANCA) test for autoimmunity and vasculitis

Abstract

Aim: Antineutrophil cytoplasmic antibodies (ANCA) autoantibodies target neutrophil and monocyte lysosomal granules. The objective of the study is to investigate patients with a positive ANCA test for autoimmune disorders and vasculitis. Materials and Methods: This 4-year retrospective cohort research analyzed 9.480 Turkish tertiary hospital serum samples. The baseline evaluation included 218 eligible ANCA-positive patients with vasculitis (AAV) and other autoimmune and non-autoimmune diseases. Results: The other two groups have less pulmonary, renal, ear nose and throat (ENT), ophthalmic, and neurologic involvement than AAV individuals. AAV and autoimmune disease patients have higher joint and skin involvement than non-autoimmune disease patients. Hypertension and chronic renal failure are more common in AAV and non-autoimmune individuals than autoimmune ones. Chronic obstructive pulmonary disease (COPD) and proteinuria are higher in AAV patients than autoimmune disease patients. AAV patients have more hematuria than the other two. For non-autoimmune disease, myeloperoxidase (MPO) titer and erythrocyte sedimentation rate (ESR) are higher than for autoimmune disease. High proteinase 3 (PR3) titers are associated with AAV and autoimmune disorders. AAV patients have higher CRP and complement 3(C3) than the other two groups. In AAV, C4 and rheumatoid factor (RF) are higher than in non-autoimmune disease. Patients with autoimmune disease had higher initial GFR than the other two groups. Conclusion: We concluded that ANCA may be positive in numerous AAV-like diseases. A tertiary hospital found a strong correlation between ANCA titers, particularly PR3, and AAV clinical diagnosis. ANCA titre and organ system extent may be clinical AAV diagnostic indicators.

Keywords

• ntineutrophil cytoplasmic antibody
• myelopreoxidase
• proteinase 3
• autoimmune
• vasculitis

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