ANCA-associated vasculitis with dual ANCA positivity in coexistence with mixed connective tissue disease

Mod Rheumatol. 2013 Jan;23(1):156-61. doi: 10.1007/s10165-012-0619-8. Epub 2012 Mar 3.

Abstract

We here report a rare case of dual antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in a 38-year-old Japanese woman previously diagnosed with mixed connective tissue disease. The patient was found to be positive for myeloperoxidase- and proteinase 3-ANCA, and was diagnosed with AAV following admission to hospital with fervescence, polyarthralgia, purpura, and asymmetric numbness of the extremities. Examination of her genetic background revealed that she carried HLA-DR9, which confers risk of both diseases in Japanese populations.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / blood
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / complications*
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / genetics
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / pathology*
  • Antibodies, Antineutrophil Cytoplasmic / blood
  • Antibodies, Antineutrophil Cytoplasmic / immunology
  • Azathioprine / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Genetic Predisposition to Disease
  • Glucocorticoids / therapeutic use
  • HLA-DR Serological Subtypes / genetics
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Methylprednisolone / therapeutic use
  • Mixed Connective Tissue Disease / blood
  • Mixed Connective Tissue Disease / complications*
  • Mixed Connective Tissue Disease / genetics
  • Mixed Connective Tissue Disease / pathology*
  • Myeloblastin / blood
  • Myeloblastin / immunology
  • Peroxidase / blood
  • Peroxidase / immunology
  • Prednisolone / therapeutic use
  • Pulse Therapy, Drug
  • Risk Factors
  • Treatment Outcome

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Glucocorticoids
  • HLA-DR Serological Subtypes
  • HLA-DR9 antigen
  • Immunosuppressive Agents
  • Prednisolone
  • Peroxidase
  • Myeloblastin
  • Azathioprine
  • Methylprednisolone