Mixed connective tissue disease associated with antineutrophil cytoplasmic antibodies against proteinase-3 and systemic atherosclerosis: a case report.
A 47-year-old woman presented with facial spasm, swollen fingers and Raynaud's phenomenon due to cerebrovascular disorder and mixed connective tissue disease (MCTD). Although she was positive for both antineutrophil cytoplasmic antibodies against proteinase-3 (PR3-ANCA) and anti-U1 RNP antibodies, she did not meet the American College of Rheumatology classification criteria for Wegener's granulomatosis (WG). Physical and histopathological examinations revealed severe systemic atherosclerosis without any of the traditional risk factors. Elevated levels of malondialdehyde-modified LDL and antioxidized LDL autoantibodies, which are considered to be key factors in the pathogenesis of atherosclerosis, were also detected in the serum of this patient. In this case, systemic atherosclerosis might have been linked to these autoimmune reactions.
Department of Internal Medicine, Nagaoka Central General Hospital, Japan.
Masato
M
Kanazawa
Yoko
Y
Wada
Tsukasa
T
Ohno
Hian
H
In
Kazuaki
K
Yahata
Junko
J
Izumi
Hisao
H
Tanaka
Satoshi
S
Ito
Mitsuhiro
M
Ueno
Masaaki
M
Nakano
Fumitake
F
Gejyo
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology*; D001161:Arteriosclerosis / Q000150:complications* / Q000473:pathology; D001241:Aspirin / Q000627:therapeutic use; D001323:Autoantibodies / Q000276:immunology; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000276:immunology; D006801:Humans; D015227:Lipid Peroxidation; D008315:Malondialdehyde / Q000378:metabolism; D008875:Middle Aged; D008947:Mixed Connective Tissue Disease / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D053146:Myeloblastin; D011239:Prednisolone / Q000627:therapeutic use; D011341:Probucol / Q000627:therapeutic use; D012697:Serine Endopeptidases / Q000097:blood / Q000276:immunology*; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use
D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D008078:Cholesterol, LDL; D008315:Malondialdehyde; D014635:Valproic Acid; D011239:Prednisolone; D012697:Serine Endopeptidases; D053146:Myeloblastin; D011341:Probucol; D001241:Aspirin