title: Multispecific anti neutrophil cytoplasm antibodies: a case report.
abstract: OBJECTIVE
  To report the presence af ANCA with an unusual polyreactivity.
  
  
  METHODS
  50 year-old woman with pulmonary fibrosis whose immunological investigations showed the presence of ANCA with an unusual polyreactivity against several neutrophil proteins (PR3,MPO, BPI, lysozyme, elastase and cathepsine G) which could be related to a polyclonal hypergammaglobulinemia occurring in this patient.
  
  
  CONCLUSIONS
  The international consensus on the testing of ANCA recommends seeking major specificities like MPO and PR3 which are good markers of ANCA-associated vasculitides. The use of multiantigenic ELISA can be helpful to detect various target antigens at the same time and may thus explain some atypical fluorescent patterns observed when searching for ANCA by Indirect immunofluorescence, these results, however, must be interpreted with caution.
authors.affiliation: Service de pneumologie D EPS Abderrahmane Mami, Tunisia.
authors.forename: Marouane
authors.initials: M
authors.lastname: Haddad
authors.forename: Meherzia
authors.initials: M
authors.lastname: Bourguiba
authors.forename: Najla
authors.initials: N
authors.lastname: Ghrairi
authors.forename: Hayet
authors.initials: H
authors.lastname: Bouakkez
authors.forename: Ibtissem
authors.initials: I
authors.lastname: Nahdi
authors.forename: Awatef
authors.initials: A
authors.lastname: Dahmouni
authors.forename: Ikram
authors.initials: I
authors.lastname: Drira
authors.forename: Sadok
authors.initials: S
authors.lastname: Yalaoui
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D023181:Antimicrobial Cationic Peptides / Q000276:immunology; D001798:Blood Proteins / Q000276:immunology; D056649:Cathepsin G / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D009113:Muramidase / Q000276:immunology; D010196:Pancreatic Elastase / Q000276:immunology; D009195:Peroxidase / Q000276:immunology; D057057:Serine Proteases / Q000276:immunology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D023181:Antimicrobial Cationic Peptides; D001798:Blood Proteins; C021623:bactericidal permeability increasing protein; D009195:Peroxidase; D009113:Muramidase; D057057:Serine Proteases; D056649:Cathepsin G; D010196:Pancreatic Elastase