title: Vasculitis and bronchiectasis in a patient with antibodies to bactericidal/permeability-increasing protein and alpha1-antitrypsin deficiency.
abstract: A patient with alpha1-antitrypsin deficiency is reported herein; this subject developed aggressive bronchial disease and recurrent cutaneous vasculitis after pulmonary infection with Pseudomonas aeruginosa. Autoantibodies to neutrophil cytoplasmic antigens were detected, which produced granular cytoplasmic staining by indirect immunofluorescence with specificity for a newly characterized antigen: bactericidal/permeability-increasing protein (BPI). The bronchial disease and vasculitis improved, and the IgA anti-BPI titer fell after antipseudomonal treatment. This raises the possibility that anti-BPI antibodies contributed to both the bronchial disease and vasculitis.
authors.affiliation: Department of Respiratory Medicine, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: R
authors.initials: R
authors.lastname: Mahadeva
authors.forename: M H
authors.initials: MH
authors.lastname: Zhao
authors.forename: S
authors.initials: S
authors.lastname: Stewart
authors.forename: N
authors.initials: N
authors.lastname: Cary
authors.forename: C
authors.initials: C
authors.lastname: Flower
authors.forename: M
authors.initials: M
authors.lastname: Lockwood
authors.forename: J
authors.initials: J
authors.lastname: Shneerson
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D023181:Antimicrobial Cationic Peptides; D001323:Autoantibodies / Q000097:blood*; D001706:Biopsy; D001770:Blood Bactericidal Activity / Q000276:immunology*; D001798:Blood Proteins / Q000276:immunology*; D001987:Bronchiectasis / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000150:complications / Q000175:diagnosis; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000150:complications / Q000175:diagnosis; D012008:Recurrence; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000175:diagnosis* / Q000209:etiology; D019896:alpha 1-Antitrypsin Deficiency / Q000175:diagnosis* / Q000209:etiology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D023181:Antimicrobial Cationic Peptides; D001323:Autoantibodies; D001798:Blood Proteins; D007070:Immunoglobulin A; D008565:Membrane Proteins; C021623:bactericidal permeability increasing protein