Antigen specificity in hydralazine associated ANCA positive systemic vasculitis.
The anti-hypertensive agent hydralazine can cause a lupus-like syndrome characterized by serosal inflammation, arthralgias and rashes. The kidneys however are usually spared. The condition is characterized by circulating immune complexes and antinuclear antibodies, whilst antibodies against double-stranded DNA are rare. Hydralazine can also cause a systemic vasculitis with a pauci-immune rapidly progressive glomerulonephritis, which is associated with autoantibodies directed against components of the neutrophil cytoplasm. In this study, ten patients with hydralazine-induced vasculitis had antibodies with specificities for both myeloperoxidase and lactoferrin. We suggest that this particular pattern of autoantibodies, together with antibodies with reactivity against nuclear components including double-stranded DNA, are characteristic findings in hydralazine-induced vasculitis. In addition, renal involvement appears to be more common in this group of patients with vasculitis than in those with the lupus-like syndrome.
Department of Medicine, School of Clinical Medicine, University of Cambridge, UK.
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D000328:Adult; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic; D000959:Antihypertensive Agents / Q000009:adverse effects*; D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D000939:Epitopes / Q000276:immunology*; D005260:Female; D006801:Humans; D006830:Hydralazine / Q000009:adverse effects; D007781:Lactoferrin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000097:blood; D012189:Retrospective Studies; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced / Q000276:immunology*
D019268:Antibodies, Antineutrophil Cytoplasmic; D000959:Antihypertensive Agents; D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; D000939:Epitopes; D006830:Hydralazine; D009195:Peroxidase; D007781:Lactoferrin