Araştırma Makalesi
BibTex RIS Kaynak Göster

Impact of Various ANA Results and ANCA Serotypes on the Outcome of Patients with ANCA-Associated Vasculitis

Yıl 2026, Cilt: 6 Sayı: 1, 23 - 29, 19.01.2026

Öz

Aim: We aimed to demostrate how antinuclear antibody (ANA) and ANCA serotypes affect ANCA-associated vasculitis (AAV) patients' results.
Material method: This retrospective cohort analysis analyzed 10,726 Turkish tertiary hospital serum samples over 4.5 years. ANCA indirect immunofluorescence test (IIF) and ANCA Enzyme-Linked Immunosorbent Assay (ELISA) testing were requested by all patients.
Results: Among 10,726 patients, there were 920 patients with positive ANCA IIF and/or ANCA ELISA test. Of the 920 patients, 18 of the 98 patients with AAV were concomitant connective tissue patients, so 80 AAV patients were included in the study. Organ involvement in these very rare patients was pulmonary (63.75%), ear-nose-throat (43.75%), renal (38.75%), joint (38.75%), skin (20%), neurological (20%), ocular (17.5%), gastrointestinal (11.25%), and cardiac (2.5%) systems. Proteinuria (51.25%), renal biopsy (48.75%), hematuria (37.5%), hypertension (56.25%), chronic renal failure (36.25%), diabetes (21.25%), coronary artery disease (10%), and asthma (8.75%) were present. ANA was found in 42.5% of 80 patients. Renal involvement and coronary artery disease were more common in ANA-positive patients (p =.0,14 and p=0.50). ANA-negative patients had higher ear, nose, and throat involvement (p=.026). PR3–ANCA individuals had higher ocular involvement (p =.020). In MPO-ANCA individuals, asthma was more common (p=.002).
Conclusion: AAV patients with ANA had more renal impairment than those without. Renal biopsy is recommended to distinguish AAV from systemic lupus erythematosus. Eye morbidity is greater in PR3-ANCA. The effects of ANA and ANCA serotypes in AAV patients need more study.

Kaynakça

  • Tsukui D, Kimura Y, Kono H. Pathogenesis and pathology of anti-neutrophil cytoplasmic antibody-associated vasculitis. J Transl Autoimmun. 2021; 4:100094.
  • Davies D, Moran J, Niall J, Ryan G. Segmental necrotising glomerulonephritis with antineutrophil antibody: possible arbovirus aetiology? Br Med J (Clin Res Ed). 1982;285(6342): 606.
  • Savige J, Trevisin M, Pollock W. Testing and reporting antineutrophil cytoplasmic antibodies (ANCA) in treated vasculitis and non-vasculitic disease. J Immunol Methods. 2018; 458:1-7.
  • Folci M, Ramponi G, Solitano V, Brunetta E. Serum-associated disease biomarkers: clinical implications beyond vasculitis. Clin Rev Allergy Immunol. 2022;63(2):107–123.
  • Hogan SL, Nachman PH, Wilkman AS, Jennette JC, Falk RJ. Prognostic markers in patients with antineutrophil cytoplasmic autoantibody-associated microscopic polyangiitis and glomerulonephritis. J Am Soc Nephrol. 1996;7(1):23-32.
  • Savige J, Davies D, Falk RJ, Jennette JC, Wiik A. Antineutrophil cytoplasmic antibodies and associated diseases: a review of the clinical and laboratory features. Kidney Int. 2000;57(3):846-862.
  • Savige JA, Chang L, Wilson D, Buchanan RR. Autoantibodies and target antigens in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides. Rheumatol Int. 1996;16(3):109-114.
  • Lenert P, Icardi M, Dahmoush L. ANA (+) ANCA (+) systemic vasculitis associated with the use of minocycline: case-based review. Clin Rheumatol. 2013 Jul;32(7):1099-1106.
  • Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65(1):1-11.
  • Chung SA, Langford CA, Maz M, et al. 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the management of antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol. 2021;73(8):1366–1383.
  • Wójcik K, Masiak A, Jeleniewicz R, Jakuszko K, Brzosko I, Storoniak H, et al. Association of antineutrophil cytoplasmic antibody (ANCA) specificity with demographic and clinical characteristics of patients with ANCA associated vasculitides. Pol Arch Intern Med. 2022 Mar 30;132(3):16187.
  • Monti S, Craven A, Klersy C, Montecucco C, Caporali R, Watts R, et al. Association between age at disease onset of anti-neutrophil cytoplasmic antibody-associated vasculitis and clinical presentation and short-term outcomes. Rheumatology (Oxford). 2021 Feb 1;60(2):617-628.
  • McGovern D, Williams SP, Parsons K, Farrah TE, Gallacher PJ, Miller-Hodges E, et al. Long-term outcomes in elderly patients with ANCA-associated vasculitis. Rheumatology (Oxford). 2020;59(5):1076-1083.
  • Mohammad AJ, Segelmark M. A population-based study showing better renal prognosis for proteinase 3 antineutrophil cytoplasmic antibody (ANCA)-associated nephritis versus myeloperoxidase ANCA-associated ne¬phritis. J Rheumatol. 2014;41(7):1366–1373.
  • Lionaki S, Blyth ER, Hogan SL, Hu Y, Senior BA, Jennette CE, et al. Classification of antineutrophil cytoplasmic autoantibody vasculitides: the role of antineutrophil cytoplasmic autoantibody specificity for myeloperoxidase or proteinase 3 in disease recognition and prognosis. Arthritis Rheum. 2012;64(10):3452-3462.
  • Zhao X, Wen Q, Qiu Y, Huang F. Clinical and pathological characteristics of ANA/anti-dsDNA positive patients with antineutrophil cytoplasmic autoantibody-associated vasculitis. Rheumatol Int. 2021;41(2):455-462.
  • Chen M, Yu F, Zhang Y, Zhao MH. Clinical and pathological characteristics of Chinese patients with antineutrophil cytoplasmic autoantibody associated systemic vasculitides: a study of 426 patients from a single centre. Postgrad Med J. 2005;81(961):723-727.
  • Tidman M, Olander R, Svalander C, Danielsson D. Patients hospitalized because of small vessel vasculitides with renal involvement in the period 1975-95: organ involvement, anti-neutrophil cytoplasmic antibodies patterns, seasonal attack rates and fluctuation of annual frequencies. J Intern Med. 1998;244(2):133-141.
  • Pagnoux C, Hogan SL, Chin H, Jennette JC, Falk RJ, Guillevin L, et al. Predictors of treatment resistance and relapse in antineutrophil cytoplasmic antibody-associated small-vessel vasculitis: comparison of two independent cohorts. Arthritis Rheum. 2008;58(9):2908-2918.
  • Hogan SL, Falk RJ, Chin H, Cai J, Jennette CE, Jennette JC, Nachman PH. Predictors of relapse and treatment resistance in antineutrophil cytoplasmic antibody-associated small-vessel vasculitis. Ann Intern Med. 2005;143(9):621-631.
  • Watts RA, Mahr A, Mohammad AJ, Gatenby P, Basu N, Flores-Suárez LF. Classification, epidemiology and clinical subgrouping of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Nephrol Dial Transplant. 2015;30:i14-i22.
  • Berti A, Cornec-Le Gall E, Cornec D, Casal Moura M, Matteson EL, Crowson CS, et al. Incidence, prevalence, mortality and chronic renal damage of anti-neutrophil cytoplasmic antibody-associated glomerulonephritis in a 20-year population-based cohort. Nephrol Dial Transplant. 2019;34(9):1508-1517.
  • Lyons PA, Rayner TF, Trivedi S, Holle JU, Watts RA, Jayne DR, et al. Genetically distinct subsets within ANCA-associated vasculitis. N Engl J Med. 2012;367(3):214-223.
  • Pagnoux C, Springer J. Editorial: Classifying Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitides According to ANCA Type or Phenotypic Diagnosis: Salt or Pepper? Arthritis Rheumatol. 2016;68(12):2837-2840.
  • Brix SR, Noriega M, Tennstedt P, Vettorazzi E, Busch M, Nitschke M, et al. Development and validation of a renal risk score in ANCA-associated glomerulonephritis. Kidney Int. 2018;94(6):1177-1188.
  • Qi F, Hao J, Wei W. Impact of different ANCA serotypes on the long-term outcome of ANCA-associated vasculitis patients. Ann Med. 2023;55(2):2289614.
  • Rekvig OP. Anti-dsDNA antibodies as a classification criterion and a diagnostic marker for systemic lupus erythematosus: critical remarks. Clin Exp Immunol. 2015;179(1):5-10.
  • Deka S, Kalita D, Rekha US, Mahanta P, Rani D, Shankar R, et al. Interference of Antinuclear Antibody (ANA) in Indirect Immunofluorescence Assay (IIFA)-Based Perinuclear Antineutrophil Cytoplasmic Antibody (pANCA) Interpretation. Autoimmune Dis. 2022; 2022:1343805.
  • Kitching AR, Anders HJ, Basu N, Brouwer E, Gordon J, Jayne DR, et al. ANCA-associated vasculitis. Nat Rev Dis Primers. 2020:27;6(1):71

ANCA İlişkili Vaskülitli Hastaların Sonuçlarına Çeşitli ANA Sonuçlarının ve ANCA Serotiplerinin Etkisi

Yıl 2026, Cilt: 6 Sayı: 1, 23 - 29, 19.01.2026

Öz

Amaç: Bu çalışmada, antinükleer antikor (ANA) ve antinötrofil sitoplazmik antikor (ANCA) serotiplerinin ANCA ile ilişkili vaskülit (AAV) hastalarının sonuçlarını nasıl etkilediğini göstermeyi amaçladık.
Gereç ve yöntem: Bu retrospektif kohort analizi, 4,5 yıl boyunca üçüncü basamak bir hastanede 10.726 serum örneğini analiz etmiştir. Tüm hastalardan ANCA indirekt immünofloresan testi (IIF) ve Enzim-Linked İmmünosorbent Assay (ELISA) istenmiştir.
Bulgular: 10.726 hasta arasında, ANCA IIF ve/veya ANCA ELISA testi pozitif olan 920 hasta vardı. 920 hastanın 98'i AAV hastasıydı ve bunların 18'i eşlik eden bağ dokusu hastasıydı, bu nedenle 80 AAV hastası çalışmaya dahil edildi. Çok nadir görülen bu hastaların organ tutulumu pulmoner (%63,75), kulak-burun-boğaz (%43,75), renal (%38,75), eklem (%38,75), deri (%20), nörolojik (%20), oküler (%17,5), gastrointestinal (11,25%) ve kardiyak (2,5%) olmuştur . Proteinüri (%51,25), böbrek biyopsisi (%48,75), hematüri (%37,5), hipertansiyon (%56,25), kronik böbrek yetmezliği (%36,25), diyabet (%21,25), koroner arter hastalığı (%10) ve astım (%8,75) mevcuttu. ANA, 80 hastanın %42,5'inde saptandı. ANA pozitif hastalarda böbrek tutulumu ve koroner arter hastalığı daha yaygındı (p = 0,14 ve p = 0,50). ANA negatif hastalarda kulak, burun ve boğaz tutulumu daha yüksekti (p = 0,026). PR3-ANCA'lı bireylerde göz tutulumu daha yüksekti (p = 0,020). MPO-ANCA bireylerde astım daha yaygındı (p=.002).
Sonuç: ANA'lı AAV hastalarında, ANA'sız hastalara göre böbrek yetmezliği daha yaygındı. AAV'yi sistemik lupus eritematozusdan ayırt etmek için böbrek biyopsisi önerilir. Göz morbiditesi PR3-ANCA'da daha yüksektir. AAV hastalarında ANA ve ANCA serotiplerinin etkileri daha fazla araştırılmalıdır.

Kaynakça

  • Tsukui D, Kimura Y, Kono H. Pathogenesis and pathology of anti-neutrophil cytoplasmic antibody-associated vasculitis. J Transl Autoimmun. 2021; 4:100094.
  • Davies D, Moran J, Niall J, Ryan G. Segmental necrotising glomerulonephritis with antineutrophil antibody: possible arbovirus aetiology? Br Med J (Clin Res Ed). 1982;285(6342): 606.
  • Savige J, Trevisin M, Pollock W. Testing and reporting antineutrophil cytoplasmic antibodies (ANCA) in treated vasculitis and non-vasculitic disease. J Immunol Methods. 2018; 458:1-7.
  • Folci M, Ramponi G, Solitano V, Brunetta E. Serum-associated disease biomarkers: clinical implications beyond vasculitis. Clin Rev Allergy Immunol. 2022;63(2):107–123.
  • Hogan SL, Nachman PH, Wilkman AS, Jennette JC, Falk RJ. Prognostic markers in patients with antineutrophil cytoplasmic autoantibody-associated microscopic polyangiitis and glomerulonephritis. J Am Soc Nephrol. 1996;7(1):23-32.
  • Savige J, Davies D, Falk RJ, Jennette JC, Wiik A. Antineutrophil cytoplasmic antibodies and associated diseases: a review of the clinical and laboratory features. Kidney Int. 2000;57(3):846-862.
  • Savige JA, Chang L, Wilson D, Buchanan RR. Autoantibodies and target antigens in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides. Rheumatol Int. 1996;16(3):109-114.
  • Lenert P, Icardi M, Dahmoush L. ANA (+) ANCA (+) systemic vasculitis associated with the use of minocycline: case-based review. Clin Rheumatol. 2013 Jul;32(7):1099-1106.
  • Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65(1):1-11.
  • Chung SA, Langford CA, Maz M, et al. 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the management of antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol. 2021;73(8):1366–1383.
  • Wójcik K, Masiak A, Jeleniewicz R, Jakuszko K, Brzosko I, Storoniak H, et al. Association of antineutrophil cytoplasmic antibody (ANCA) specificity with demographic and clinical characteristics of patients with ANCA associated vasculitides. Pol Arch Intern Med. 2022 Mar 30;132(3):16187.
  • Monti S, Craven A, Klersy C, Montecucco C, Caporali R, Watts R, et al. Association between age at disease onset of anti-neutrophil cytoplasmic antibody-associated vasculitis and clinical presentation and short-term outcomes. Rheumatology (Oxford). 2021 Feb 1;60(2):617-628.
  • McGovern D, Williams SP, Parsons K, Farrah TE, Gallacher PJ, Miller-Hodges E, et al. Long-term outcomes in elderly patients with ANCA-associated vasculitis. Rheumatology (Oxford). 2020;59(5):1076-1083.
  • Mohammad AJ, Segelmark M. A population-based study showing better renal prognosis for proteinase 3 antineutrophil cytoplasmic antibody (ANCA)-associated nephritis versus myeloperoxidase ANCA-associated ne¬phritis. J Rheumatol. 2014;41(7):1366–1373.
  • Lionaki S, Blyth ER, Hogan SL, Hu Y, Senior BA, Jennette CE, et al. Classification of antineutrophil cytoplasmic autoantibody vasculitides: the role of antineutrophil cytoplasmic autoantibody specificity for myeloperoxidase or proteinase 3 in disease recognition and prognosis. Arthritis Rheum. 2012;64(10):3452-3462.
  • Zhao X, Wen Q, Qiu Y, Huang F. Clinical and pathological characteristics of ANA/anti-dsDNA positive patients with antineutrophil cytoplasmic autoantibody-associated vasculitis. Rheumatol Int. 2021;41(2):455-462.
  • Chen M, Yu F, Zhang Y, Zhao MH. Clinical and pathological characteristics of Chinese patients with antineutrophil cytoplasmic autoantibody associated systemic vasculitides: a study of 426 patients from a single centre. Postgrad Med J. 2005;81(961):723-727.
  • Tidman M, Olander R, Svalander C, Danielsson D. Patients hospitalized because of small vessel vasculitides with renal involvement in the period 1975-95: organ involvement, anti-neutrophil cytoplasmic antibodies patterns, seasonal attack rates and fluctuation of annual frequencies. J Intern Med. 1998;244(2):133-141.
  • Pagnoux C, Hogan SL, Chin H, Jennette JC, Falk RJ, Guillevin L, et al. Predictors of treatment resistance and relapse in antineutrophil cytoplasmic antibody-associated small-vessel vasculitis: comparison of two independent cohorts. Arthritis Rheum. 2008;58(9):2908-2918.
  • Hogan SL, Falk RJ, Chin H, Cai J, Jennette CE, Jennette JC, Nachman PH. Predictors of relapse and treatment resistance in antineutrophil cytoplasmic antibody-associated small-vessel vasculitis. Ann Intern Med. 2005;143(9):621-631.
  • Watts RA, Mahr A, Mohammad AJ, Gatenby P, Basu N, Flores-Suárez LF. Classification, epidemiology and clinical subgrouping of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Nephrol Dial Transplant. 2015;30:i14-i22.
  • Berti A, Cornec-Le Gall E, Cornec D, Casal Moura M, Matteson EL, Crowson CS, et al. Incidence, prevalence, mortality and chronic renal damage of anti-neutrophil cytoplasmic antibody-associated glomerulonephritis in a 20-year population-based cohort. Nephrol Dial Transplant. 2019;34(9):1508-1517.
  • Lyons PA, Rayner TF, Trivedi S, Holle JU, Watts RA, Jayne DR, et al. Genetically distinct subsets within ANCA-associated vasculitis. N Engl J Med. 2012;367(3):214-223.
  • Pagnoux C, Springer J. Editorial: Classifying Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitides According to ANCA Type or Phenotypic Diagnosis: Salt or Pepper? Arthritis Rheumatol. 2016;68(12):2837-2840.
  • Brix SR, Noriega M, Tennstedt P, Vettorazzi E, Busch M, Nitschke M, et al. Development and validation of a renal risk score in ANCA-associated glomerulonephritis. Kidney Int. 2018;94(6):1177-1188.
  • Qi F, Hao J, Wei W. Impact of different ANCA serotypes on the long-term outcome of ANCA-associated vasculitis patients. Ann Med. 2023;55(2):2289614.
  • Rekvig OP. Anti-dsDNA antibodies as a classification criterion and a diagnostic marker for systemic lupus erythematosus: critical remarks. Clin Exp Immunol. 2015;179(1):5-10.
  • Deka S, Kalita D, Rekha US, Mahanta P, Rani D, Shankar R, et al. Interference of Antinuclear Antibody (ANA) in Indirect Immunofluorescence Assay (IIFA)-Based Perinuclear Antineutrophil Cytoplasmic Antibody (pANCA) Interpretation. Autoimmune Dis. 2022; 2022:1343805.
  • Kitching AR, Anders HJ, Basu N, Brouwer E, Gordon J, Jayne DR, et al. ANCA-associated vasculitis. Nat Rev Dis Primers. 2020:27;6(1):71
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Mikrobiyoloji, Klinik Tıp Bilimleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Emrah Salman 0000-0002-5293-0803

Gönderilme Tarihi 17 Ağustos 2025
Kabul Tarihi 29 Aralık 2025
Yayımlanma Tarihi 19 Ocak 2026
Yayımlandığı Sayı Yıl 2026 Cilt: 6 Sayı: 1

Kaynak Göster