title: Anti-MPO-ANCA-positive microscopic polyangiitis following subacute bacterial endocarditis.
abstract: Although infectious agents such as Staphylococcus aureus have been implicated in the pathogenesis of Wegener's granulomatosis, the role of bacterial infections in the pathogenesis of other types of small-vessel vasculitides associated with antineutrophil cytoplasmic antibodies (ANCA) is less clear. We describe a patient who developed a non-granulomatous necrotising small vessel vasculitis and perinuclear ANCA (p-ANCA) directed against myeloperoxidase (MPO) after recurrent episodes of bacterial endocarditis due to Staph. aureus. Although cytoplasmic ANCA (c-ANCA) directed against proteinase 3 have been reported in single patients with bacterial endocarditis, to our knowledge this patient is the first reported case of an anti-MPO-ANCA positive systemic vasculitis following bacterial endocarditis.
authors.affiliation: Universitätsklinik Bergmannsheil, Ruhr-Universität Bochum, Germany. Bernhard.Hellmich@ruhr-uni-bochum.de
authors.forename: B
authors.initials: B
authors.lastname: Hellmich
authors.forename: M
authors.initials: M
authors.lastname: Ehren
authors.forename: M
authors.initials: M
authors.lastname: Lindstaedt
authors.forename: M
authors.initials: M
authors.lastname: Meyer
authors.forename: M
authors.initials: M
authors.lastname: Pfohl
authors.forename: H
authors.initials: H
authors.lastname: Schatz
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D004698:Endocarditis, Subacute Bacterial / Q000150:complications*; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009195:Peroxidase / Q000276:immunology*; D012008:Recurrence; D013203:Staphylococcal Infections / Q000150:complications*; D014657:Vasculitis / Q000209:etiology* / Q000276:immunology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D009195:Peroxidase