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1. 抗好中球細胞質抗体の臨床的な意味clinical spectrum of antineutrophil cytoplasmic autoantibodies [show details]
… responsible. The perinuclear ANCA (P-ANCA) pattern results from a staining pattern around the nucleus, which represents an artifact of ethanol fixation. With ethanol fixation of the neutrophil substrate …
2. 多発血管炎性肉芽腫症を伴う肉芽腫症および関連血管炎の病因pathogenesis of granulomatosis with polyangiitis and related vasculitides [show details]
…PR3-ANCA cause a cytoplasmic pattern of neutrophil staining (a "C-ANCA" pattern). By contrast, MPO antigens migrate toward the nucleus, and sera containing MPO-ANCA lead to a perinuclear ("P-ANCA") pattern …
3. 薬物誘発性ループスdrug induced lupus [show details]
… A positive ANA (including anti-double-stranded [ds]DNA antibodies) and perinuclear antineutrophil cytoplasmic antibody (P-ANCA) test have been found in 92 and 83 percent of tested sera, respectively; …
4. 多発血管炎性肉芽腫症および顕微鏡的多発血管炎：気道病変granulomatosis with polyangiitis and microscopic polyangiitis respiratory tract involvement [show details]
… alveolar hemorrhage with crescentic glomerulonephritis have been reported in association with perinuclear ANCA (P-ANCA) positivity (positive myeloperoxidase) . Typically, these patients also have positive antinuclear …
5. 好酸球性肉芽腫性多発血管炎(チャーグ・ストラウス症候群）の臨床的特徴および診断clinical features and diagnosis of eosinophilic granulomatosis with polyangiitis churg strauss [show details]
… Antineutrophil cytoplasmic antibodies (ANCAs) are noted in 30 to 60 percent of EGPA patients. The majority of ANCAs associated with EGPA are directed against myeloperoxidase with a perinuclear staining …

English Journal

Anti-neutrophil cytoplasmic antibody associated central nervous system vasculitis with brain and spinal cord subarachnoid hemorrhage: A rare case report and review of the literature.

Harland TA, Seinfeld J, Cava LF, Neumann RT, Roark C, Kumpe D, Case D.
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 2019 Apr;62()253-255.
This case report describes a 48-year old female who presented with altered mental status, lower extremity weakness, low back pain and a recent history of subjective fevers and night sweats found to have posterior parieto-occipital and spinal subarachnoid hemorrhage on imaging. Further work-up reveal
PMID 30594448

The clinical usage and definition of autoantibodies in immune-mediated liver disease: A comprehensive overview.

Terziroli Beretta-Piccoli B, Mieli-Vergani G, Vergani D.
Journal of autoimmunity. 2018 Dec;95()144-158.
Autoimmune serology is key to the diagnosis and management of autoimmune liver diseases. Its correct use in clinical practice requires a basic knowledge of the laboratory techniques used for autoantibody detection. Indirect immunofluorescence (IIF) on triple rodent tissue is still the gold standard
PMID 30366656

Microscopic polyangiitis secondary to Mycobacterium abscessus in a patient with bronchiectasis: a case report.

Addy C, Doran G, Jones AL, Wright G, Caskey S, Downey DG.
BMC pulmonary medicine. 2018 Nov;18(1)170.
Non-Tuberculous Mycobacterial-pulmonary disease (NTM-PD) is increasing in incidence and prevalence. Mycobacterium abscessus (M.abscessus) is a rapid growing multi-resistant NTM associated with severe NTM-PD requiring prolonged antibiotic therapy. Complications of therapy are common but reports on di
PMID 30453935

Japanese Journal

ANCA関連血管炎にともなって眼窩先端症候群を呈した1例

岩波弘明,加藤大貴,大中洋平,中島雅士,河村満
臨床神経学 54(2), 158-161, 2014
症例は73歳男性である．1週間で進行する複視と左眼視力低下で入院した．左眼は全盲で，かつ眼瞼下垂と全外眼筋麻痺をみとめた．MRIで眼窩先端近傍に異常をみとめず，右上顎洞と左乳突蜂巣に異常T<sub>2</sub>高信号をみとめた．血液検査では赤沈の亢進とMPO-ANCA陽性をみとめた．メチルプレドニゾロン・パルス治療によって複視はすみやかに改善し，MRI異常信号は消失した． …
NAID 130004505564

耳症状初発の限局型ウェゲナー肉芽腫症例

小林礼子,西池季隆,神原留美 [他],荻野仁,久保武,武田憲昭
耳鼻咽喉科臨床 97(8), 685-690, 2004-08-01
… Perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) was positive, but cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) was negative. …
NAID 10013353632

血液透析中の慢性腎不全患者に発症したp-ANCA陽性肥厚性脳硬膜炎

田島康敬,宮崎雄生,須藤和昌 [他],松本昭久
臨床神経学 42(3), 243-246, 2002-03-01
NAID 10011037694

「MPO-ANCA」

　　[★]

英: myeloperoxidase antineutrophil cytoplasmic antibody, myeloperoxidase-anti-neutrophil cytoplasmic antibody; perinuclear antineutrophil cytoplasmic antibody, perinuclear-anti-neutrophil cytoplasmic antibody, p-ANCA
関: PR3-ANCA=C-ANCA

鑑別疾患

顕微鏡的多発血管炎(MPA)

YN.F-62

全身の小血管に炎症を来たし、全身症状が見られるが特に肺(間質性肺炎)、腎(半月体形成性糸球体腎炎)に病変が認められる。全身症状としては発熱、体重減少、多発関節炎、筋肉痛が見られ、肺出血(血痰)、進行性腎機能低下を来たし、尿検査では血尿、蛋白尿、円柱が認められる。治療はステロイドと免疫抑制薬である。重症例では血漿交換も適応となる。死因は腎不全が多い。

アレルギー性肉芽腫性血管炎 Churg-Strauss症候群

主に中動脈以下の動脈を好発部位とする壊死性肉芽腫性血管炎。高率に肺病変と好酸球増多症を認め、また好酸球の組織浸潤も著明。気管支喘息、好酸球増加、血管炎をみとめる場合、チャーグ・ストラウス症候群である。典型的組織像が見とめられればアレルギー性肉芽腫性血管炎と呼ばれる。検査では、白血球増加、血小板数増加、血清IgE増加、MPO-ANCA陽性、リウマトイド因子陽性、肺浸潤陰影が認められる。治療はステロイドや免疫抑制薬である。結節性多発動脈炎より予後良好であるが脳血管障害、呼吸不全、腸管出血、感染が死因となりうる。