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Antinevtrofilna citoplazemska protitelesa (ANCA) pri otrocih s purpuro Schoenlein-Henoch in prizadetostjo ledvic = Antineutrophil cytoplasmic antibodies (ANCA) in children with past history of Schoenlein-Henoch purpura and renal involvement
Bračič, Katarina ...
We investigated the frequency, isotype and antigen specificity of ANCA in seraof 20 children with haematuria and/or proteinuria after and acute episode of PSH and in 15 healthy age-matched controls. ...The pateint's sera were tested for perinuclear (P-ANCA), cytoplasmic (C-ANCA), and atypical ANCA by indirect immunofluorescence (IIF). By enzyme linked-immunosorbent assay (ELISA) the specificity for myeloŠeroxidase, proteinase 3, elstase, lactoferrin, capesin G, lyzosome was examined. Twenty children aged 4-15.2 years, mean 8.8 years 12F, 8 M, with past history of PSH and persistence of urinary abnormalities onfollow-up (6-40 months, mean 18 M). 17/20 had isolated microhaematuria, 1/20had recurrent macrohaematuria, 1/20 had recurrent macrohematuria and proteinuria, and 1/20 had isolated proteinuria. IIF revealed weakly positive ANCA in 9/20 patient sera and none in 15 healthy controls. 1/9 sera showed P-ANCA, and 8/9 sera showed atypical ANCA (with homogenous cytoplasmic pattern), 2 of which were IgG and IgA positive, and 6 sera IgA positive. ANtigen specificity was tested by ELISA for mieloperoxidase, proteinase 3, lactoferrin. elastase, catepsin G, lysozyme and none yielded a positive result. We concluded> The absence of C-ANCA in all patients sera assist us in differentiating between PSH and Wegener. The lack of correlation of P-ANCA andatypical ANCA with any ANCA specifity (MPO, PR3, lactoferrin, elastase, catepsin G, lysozyme) suggests that circulating IgA-ANCA may be directed against a yet unknown antigen.
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