Pitfalls with anti-neutrophil cytoplasmic antibodies (ANCA).
A 39-year-old Ugandan student is described presenting with general malaise, fever and a pulmonary infiltrate. Open lung biopsy showing infarction and positive ANCA lead to a diagnosis of Wegener's granulomatosis and a treatment with immunosuppressive drugs was instituted. Five weeks after admission, however, sputum cultures turned out to be positive for Mycobacterium tuberculosis. The importance of ANCA-interpretation and the possibility of false positive results is discussed.
De Clerck
L S
LS
Department of Rheumatology, Sint-Vincentius Hospital, Antwerp, Belgium.
Van Offel
J F
JF
Smolders
W A
WA
Empsten
F A
FA
Bridts
C H
CH
Bourgeois
N
N
Van Marck
E
E
Timmermans
U
U
Stevens
W J
WJ
D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D003593:Cytoplasm / Q000276:immunology*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009504:Neutrophils / Q000276:immunology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology
D001323:Autoantibodies