- 関
- ANCA、anti-neutrophil cytoplasmic antibody、antineutrophil cytoplasmic antibody、c-ANCA、perinuclear anti-neutrophil cytoplasmic antibody
WordNet
- send a message from one computer to another to check whether it is reachable and active; "ping your machine in the office"
- a sharp high-pitched resonant sound (as of a sonar echo or a bullet striking metal)
- contact, usually in order to remind of something; "Ill ping my accountant--April 15 is nearing"
- hit with a pinging noise; "The bugs pinged the lamp shade"
- make a short high-pitched sound; "the bullet pinged when they struck the car"
- the 16th letter of the Roman alphabet (同)p
PrepTutorEJDIC
- (小銃弾などの)ピュー(ブーン)という音 / ピュー(ブーン)と音がする
- parking
- phosphorusの化学記号
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/07/16 22:33:58」(JST)
[Wiki en表示]
Perinuclear staining typical of p-ANCA
p-ANCA, or Perinuclear Anti-Neutrophil Cytoplasmic Antibodies, show a perinuclear staining pattern.
This pattern occurs because the vast majority of the antigens targeted by ANCAs are highly cationic (Positively charged) at pH 7.00. During ethanol (pH~7.0 in water) fixation, antigens which are more cationic migrate and localize around the nucleus, attracted by its negatively charged DNA content. Antibody staining therefore results in fluorescence of the region around the nucleus.
Contents
- 1 Targets
- 2 Medical conditions
- 3 See also
- 4 References
Targets
By far the most common p-ANCA target is myeloperoxidase (MPO), a [neutrophil] granule protein whose primary role in normal metabolic processes is generation of oxygen radicals.
ANCA will less commonly form against alternative antigens that may also result in a p-ANCA pattern. These include lactoferrin; elastase; and cathepsin G.
When the condition is a vasculitis, the target is usually MPO.[1] However, the proportion of p-ANCA sera with anti-MPO antibodies has been reported to be as low as 12%.[2]
Medical conditions
p-ANCA is associated with several medical conditions:[3]
- It is fairly specific, but not sensitive for ulcerative colitis, so is not useful as a sole diagnostic test.[4] When measured together with Anti-saccharomyces cerevisiae antibodies (ASCA), p-ANCA has been estimated to have a specificity of 97% and a sensitivity of 48% in differentiating patients with ulcerative colitis from normal controls.[5]
- about 50% of cases of Churg-Strauss syndrome
- A majority of primary sclerosing cholangitis
- sometimes polyarteritis nodosa (only in the variant microscopic polyangiitis, usually negative in typical polyarteritis nodosa)
- microscopic polyangiitis [6]
- Focal necrotising and crescentic glomerulonephritis
- Rheumatoid arthritis
- Wegener's disease
See also
References
- ^ Anthony S. Fauci; Carol A. Langford (16 March 2006). Harrison's rheumatology. McGraw-Hill Professional. pp. 159–. ISBN 978-0-07-145743-9. Retrieved 1 November 2010.
- ^ Yehuda Shoenfeld; M. Eric Gershwin; Pier-Luigi Meroni (2007). Autoantibodies. Elsevier. pp. 98–. ISBN 978-0-444-52763-9. Retrieved 1 November 2010.
- ^ Mary Lee (10 March 2009). Basic Skills in Interpreting Laboratory Data. ASHP. pp. 455–. ISBN 978-1-58528-180-0. Retrieved 15 November 2010.
- ^ Shepherd B et al. (2005). "Inflammatory Bowel Disease: Diagnostic and Treatment Options". Hospital Physician: 11–19.
- ^ [1] Walker, D. G.; Bancil, A. S.; Williams, H. R.; Bunn, C.; Orchard, T. R. (2011). "How helpful are serological markers in differentiating crohn's disease from ulcerative colitis in indian asian inflammatory bowel disease patients?". Gut 60: A222–A223. doi:10.1136/gut.2011.239301.469. edit
- ^ Thomas M. Habermann; Mayo Clinic (1 November 2007). Mayo Clinic Internal Medicine Concise Textbook. CRC Press. pp. 775–. ISBN 978-1-4200-6749-1. Retrieved 15 November 2010.
Medical test: Antibodies: autoantibodies
|
|
Anti-nuclear antibody |
- PBC:
- Anti-gp210
- Anti-p62
- Anti-sp100
- ENA:
- Anti-topoisomerase/Scl-70
- Anti-Jo1
- ENA4
- Anti-Sm
- Anti-nRNP
- Anti-Ro
- Anti-La
|
|
Anti-mitochondrial antibody |
|
|
Anti-cytoplasm antibody |
- Anti-neutrophil cytoplasmic
- Anti-smooth muscle
- Anti-TPO/Antimicrosomal
|
|
Cell membrane |
- Anti-ganglioside
- Anti-GBM
|
|
Extracellular |
- Anti-thrombin
- Lupus anticoagulant
- Gluten sensitivity:
- Anti-transglutaminase
- Anti-gliadin not autoantibody
- RA
- Rheumatoid factor/anti-IgG
- Anti-citrullinated peptide
|
|
Multiple locations |
- Anti-phospholipid
- Anti-apolipoprotein
|
|
Ungrouped |
- Anti-glutamate receptor antibodies
|
|
|
cell/phys/auag/auab/comp, igrc
|
|
|
|
|
|
Vasculitis/arteritis: systemic vasculitis (M30–M31, 446)
|
|
Large vessel |
- Takayasu's arteritis
- Giant-cell arteritis
|
|
Medium vessel |
- Type III hypersensitivity
- Kawasaki disease
|
|
Small vessel |
Pauci-immune |
- c-ANCA
- Granulomatosis with polyangiitis
- p-ANCA
- Churg-Strauss syndrome
- Microscopic polyangiitis
|
|
Type III hypersensitivity |
- Hypersensitivity vasculitis/Henoch–Schönlein purpura
|
|
Ungrouped |
- Acute hemorrhagic edema of infancy
- Cryoglobulinemic vasculitis
- Bullous small vessel vasculitis
- Cutaneous small-vessel vasculitis
|
|
|
Other |
- Goodpasture's syndrome
- Sneddon's syndrome
|
|
|
anat (a:h/u/t/a/l,v:h/u/t/a/l)/phys/devp/cell/prot
|
noco/syva/cong/lyvd/tumr, sysi/epon, injr
|
proc, drug (C2s+n/3/4/5/7/8/9)
|
|
|
|
UpToDate Contents
全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.
English Journal
- Eosinophilic granulomatosis with polyangiitis (Churg-Strauss): state of the art.
- Vaglio A, Buzio C, Zwerina J.SourceDepartment of Clinical Medicine, Nephrology and Health Sciences, University Hospital of Parma, Parma, Italy.
- Allergy.Allergy.2013 Mar;68(3):261-73. doi: 10.1111/all.12088. Epub 2013 Jan 18.
- Eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA) is a systemic small-vessel vasculitis associated with asthma and eosinophilia. Histology of EGPA shows tissue eosinophilia, necrotizing vasculitis, and eosinophil-rich granulomatous inflammation. EGPA commonly presents with upper ai
- PMID 23330816
- Does searching for Antineutrophil cytoplasmic antibodies help with the diagnosis of Adult-onset Still's Disease?
- Saghafi M, Sahebari M.SourceRheumatic Diseases Research Center (RDRC), Faculty of Medicine, Mashhad University of Medical Sciences, Ghaem Hospital, Mashhad, Iran.
- Rheumatology international.Rheumatol Int.2013 Mar;33(3):571-4. doi: 10.1007/s00296-012-2377-5. Epub 2012 Mar 31.
- Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. It is a seronegative disease with multisystemic manifestations. One of the important laboratory findings in AOSD is negative results for rheumatoid factor and antinuclear antibody. Because there is no sp
- PMID 22466401
- Marfan syndrome with antineutrophil cytoplasmic antibody-associated systemic vasculitis presenting as severe anaemia and haematuria after the Bentall procedure.
- Sijia L, Shuangxin L, Wei S, Yanhai C.SourceDepartment of Nephrology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2013 Feb 22. [Epub ahead of print]
- One month previously, a 28-year old male underwent an emergency modified Bentall procedure because of Marfan syndrome with acute aortic dissection Stanford Class A. Computed tomography of the chest did not reveal severe graft stenosis of the anastomosis. To explore the cause of anaemia, renal dysfun
- PMID 23435525
Japanese Journal
- 高岡 麻里絵,萩原 晃,長谷川 達哉,小川 恭生,西山 信宏,鈴木 衞
- 耳鼻咽喉科臨床 103(3), 201-208, 2010-03-01
- … Systemic examination shared slightly elevated serum P-ANCA but negative C-ANCA. …
- NAID 10026216819
- 進行性難聴を呈したP-ANCA陽性 Wegener 肉芽腫症
- 坂口 博史,任 書晃,瀧 正勝,鈴木 敏弘,久 育男
- 耳鼻咽喉科臨床 102(7), 517-522, 2009-07-01
- … We report a case of P-ANCA positive Wegener’s granulomatosis (WG) with progressive hearing loss. … She was diagnosed as having WG based on specific symptoms in the upper respiratory tract (otitis and sinusitis), pathological findings in the nasal mucosa and blood test data including positive findings for P-ANCA. …
- NAID 10025096537
Related Links
- P-ANCAの対応抗原は主としてミエロペルオキシダーゼ(MPO)であることから、別名MPO- ANCAとも呼ばれる。P-ANCAは半月体形成性腎炎、巣状壊死性腎炎などで高頻度に検出され るが、いずれも血管炎を主体とする病態であるため、これらは「ANCA関連血管炎」 ...
Related Pictures
★リンクテーブル★
[★]
- 英
- microscopic polyangiitis, MPA
- 同
- 顕微鏡的多発性血管炎、顕微鏡的多発動脈炎 microscopic polyarteritis
- 関
- 血管炎。MPO-ANCA、ANCA関連血管炎
概念
- 古典的なクスマウル・マイアー型(Kussmaul-Maier)の多発動脈炎に対し、分節状壊死性糸球体腎炎のような微小血管炎を伴う多発動脈炎を顕微鏡型と称したのに由来する。
- 小血管の炎症であるので、小血管が集まった臓器が冒される、腎臓(急速進行型糸球体腎炎 RPGN)、肺(間質性肺炎)
定義
- CHCC 2012
- 免疫沈着を全くまたはほとんど認めない壊死性血管炎。主に小型血管(すなわち毛細血管、細静脈、または細動脈)を侵す。壊死性血管炎は小型動脈や中型動脈にも認めることがある。壊死性糸球体腎炎は非常によくみられる。肺毛細血管炎もしばしば生じる。肉芽腫性炎症は認めない。
症状
- https://www.nanbyou.or.jp/entry/245
全身症状
|
約70%
|
高血圧
|
約30%
|
皮疹
|
約60%
|
多発性単神経炎
|
約60%
|
関節痛
|
約50%
|
筋痛
|
約50%
|
間質性肺炎
|
約25%
|
肺胞出血
|
約10%
|
心不全
|
約18%
|
消化管病変
|
約20%
|
検査
尿検査
治療
- ANCA関連血管炎 診療ガイドライン2017
- https://minds.jcqhc.or.jp/n/med/4/med0094/G0000931
- ベースとなるのはステロイドであるが、単独で使われるより、組み合わせて使われていることが多い。
- どの治療が最適化は議論中のようである。
- GC
- GC+POCY/IVCY
- GC+RTX
- GC+MTX
- GC+MMF
国試
|
|
症状
|
検査
|
病理
|
治療
|
結節性多発動脈炎
|
polyarteritis nodosa,PN
|
細動脈に壊死性血管炎を引き起こす。糸球体腎炎なし。
|
① 全身症状あり ② 他臓器の虚血障害〈脳出血、肺出血、虚血性心疾患(心臓の冠動脈が虚血)〉 ③ 進行性腎機能低下、腎血管性高血圧(炎症動脈狭窄→レニン分泌)
|
尿所見に乏しい進行性腎機能低下、腰痛
|
・ 腎臓を含む多臓器の動脈に炎症が生じる。 ・ 腎動脈造影で弓状動脈に生じた結節様病変、糸球体病変は軽度。
|
ステロイド&免疫抑制剤(シクロホスファミド)
|
顕微鏡的多発動脈炎
|
microscopic polyangitis,MPA
|
小血管の炎症。糸球体腎炎あり。
|
①全身症状:発熱、体重減少、多発関節炎、筋肉痛 ②多臓器の虚血障害:肺出血(血痰) ③進行性腎機能低下(急性進行性糸球体腎炎)(高齢者のRPGNにMPAが多い)
|
①RPGN症状が(血尿、蛋白尿、円柱、週単位での腎機能低下) ②MPO-ANCA陽性が85%を占める。
|
腎の微小血管と糸球体及び、肺の微小血管に炎症が生じる。 ① 半月体形成:糸球体係蹄壁の外側に増殖した細胞が半月状の形態をとる。 ② 免疫グロブリンや補体の沈着はなし。(p-ANCAがELIZA法で検出される。)
|
|
[★]
- 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
- 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。
- 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。
[★]
肝機能検査
- plos
自己抗体
[★]
- 英
- perinuclear anti-neutrophil cytoplasmic antibody、p-ANCA
- 関
- 抗好中球細胞質抗体、細胞質型抗好中球細胞質抗体、核周辺型抗好中球細胞質抗体
[★]
- 英
- perinuclear anti-neutrophil cytoplasmic antibody、p-ANCA
- 関
- 核周囲型抗好中球細胞質抗体
[★]
抗好中球細胞質抗体 anti-neutrophil cytoplasmic antibody, antibodies to nuclear cytoplastic antigens
[★]
[★]
[★]
- 時間単位
- 関
- picosecond、psec
[★]
- 10の-12乗
- 関
- pico