title: Three cases of PR3-ANCA positive subacute endocarditis caused by attenuated bacteria (Propionibacterium, Gemella, and Bartonella) complicated with kidney injury.
abstract: Subacute bacterial endocarditis (SBE) associated with antiproteinase-3 antineutrophil cytoplasmic antibodies (PR3-ANCA) has previously been reported in 10 cases of Streptococcus viridans and in 1 case of Escherichia faecalis infection. Most of these patients had hypocomplementemia and were positive for several autoantibodies. The infections in most of these patients showed good responses to antibiotic treatment. We report three patients with ANCA-positive SBE, which was induced by attenuated slow-growing intracellular pathogens; these patients had severe complications, such as acute kidney injury, cerebral embolism, and aortic valve destruction.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Satake
authors.forename: Isao
authors.initials: I
authors.lastname: Ohsawa
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Ken
authors.initials: K
authors.lastname: Osaki
authors.forename: Hitoe
authors.initials: H
authors.lastname: Toyoda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Horikoshi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tomino
mesh_terms: D058186:Acute Kidney Injury / Q000276:immunology / Q000382:microbiology; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology; D018413:Bartonella quintana; D004698:Endocarditis, Subacute Bacterial / Q000276:immunology* / Q000382:microbiology; D017809:Fatal Outcome; D058834:Gemella; D016908:Gram-Positive Bacterial Infections / Q000150:complications* / Q000276:immunology; D006801:Humans; D008297:Male; D053146:Myeloblastin / Q000276:immunology; D011425:Propionibacterium acnes; D014205:Trench Fever / Q000150:complications* / Q000276:immunology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D053146:Myeloblastin