A case of mistaken identity: subacute bacterial endocarditis associated with p-antineutrophil cytoplasmic antibody.
Seventeen cases of subacute bacterial endocarditis (SBE) associated with antineutrophil cytoplasmic antibody (ANCA) have been reported. Fifteen such cases have been associated with c-ANCA postivity and two with dual p-ANCA and c-ANCA antibodies. The authors describe a 61-year-old man with sole p-ANCA positive autoantibodies on immunofluorescence presenting with Staphylococcus aureus SBE of the aortic valve. To the best of our knowledge this is the only reported case of sole p-ANCA positive SBE. Full recovery was achieved with antibiotic treatment. ANCAs are known to be associated with infection and their characterisation in acute illness is key in differentiating a true vasculitis from an infection. Unnecessary immunosuppression can be prevented with full investigation of such patients, including both immunofluorescence and ELISA.
The Louise Coote Lupus Unit, Guys and St Thomas Hospital NHS Foundation Trust, UK. alexriding@doctors.org.uk
A M
AM
Riding
D P
DP
D'Cruz
D019268:Antibodies, Antineutrophil Cytoplasmic; D004698:Endocarditis, Subacute Bacterial / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000276:immunology*
D019268:Antibodies, Antineutrophil Cytoplasmic