Mixed connective tissue disease associated with antineutrophil cytoplasmic antibodies against proteinase-3 and systemic atherosclerosis: a case report

Clin Rheumatol. 2004 Oct;23(5):456-9. doi: 10.1007/s10067-004-0911-x. Epub 2004 Apr 14.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Antineutrophil Cytoplasmic / immunology*
  • Arteriosclerosis / complications*
  • Arteriosclerosis / pathology
  • Aspirin / therapeutic use
  • Autoantibodies / immunology
  • Cholesterol, LDL / blood
  • Female
  • Granulomatosis with Polyangiitis / immunology
  • Humans
  • Lipid Peroxidation
  • Malondialdehyde / metabolism
  • Middle Aged
  • Mixed Connective Tissue Disease / drug therapy
  • Mixed Connective Tissue Disease / immunology*
  • Mixed Connective Tissue Disease / pathology
  • Myeloblastin
  • Prednisolone / therapeutic use
  • Probucol / therapeutic use
  • Serine Endopeptidases / blood
  • Serine Endopeptidases / immunology*
  • Treatment Outcome
  • Valproic Acid / therapeutic use

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Autoantibodies
  • Cholesterol, LDL
  • Malondialdehyde
  • Valproic Acid
  • Prednisolone
  • Serine Endopeptidases
  • Myeloblastin
  • Probucol
  • Aspirin