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International Consensus on Antineutrophil Cytoplasm Antibodies Testing in Eosinophilic Granulomatosis with Polyangiitis
- Source :
- American Journal of Respiratory and Critical Care Medicine, 202(10), 1360-1372. American Thoracic Society
- Publication Year :
- 2020
-
Abstract
- An international consensus on antineutrophil cytoplasm antibodies (ANCA) testing in eosinophilic granulomatosis with polyangiitis (EGPA) is presented. ANCA, specific for myeloperoxidase (MPO), can be detected in 30-35% of patients with EGPA. MPO-ANCA should be tested with antigen-specific immunoassays in any patient with eosinophilic asthma and clinical features suggesting EGPA, including constitutional symptoms; purpura; polyneuropathy; unexplained heart, gastrointestinal, or kidney disease; and/or pulmonary infiltrates or hemorrhage. A positive MPO-ANCA result contributes to the diagnostic workup for EGPA. Patients with MPO-ANCA-associated EGPA have vasculitis features, such as glomerulonephritis, neuropathy, and skin manifestations, more frequently than patients with ANCA-negative EGPA. However, the presence of MPO-ANCA is neither sensitive nor specific enough to identify whether a patient should be subclassified as having "vasculitic" or eosinophilic" EGPA. At present, ANCA status cannot guide treatment decisions, that is, whether cyclophosphamide, rituximab, or mepolizumab should be added to conventional glucocorticoid treatment. In EGPA, monitoring of ANCA is only useful when MPO-ANCA was tested positive at disease onset.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
Cyclophosphamide
SYSTEMIC VASCULITIS
urologic and male genital diseases
Critical Care and Intensive Care Medicine
Gastroenterology
vasculitis
03 medical and health sciences
0302 clinical medicine
immune system diseases
Internal medicine
Eosinophilic
CYCLOPHOSPHAMIDE
medicine
cardiovascular diseases
030212 general & internal medicine
RITUXIMAB
skin and connective tissue diseases
TERM-FOLLOW-UP
business.industry
ANCA
MYELOPEROXIDASE
CARDIAC INVOLVEMENT
medicine.disease
EGPA
respiratory tract diseases
eosinophilic granulomatosis with polyangiitis
CHURG-STRAUSS-SYNDROME
030228 respiratory system
consensus
Rituximab
AUTOANTIBODIES
business
Granulomatosis with polyangiitis
Vasculitis
Mepolizumab
Polyneuropathy
medicine.drug
Kidney disease
Subjects
Details
- Language :
- English
- ISSN :
- 1073449X
- Volume :
- 202
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- American Journal of Respiratory and Critical Care Medicine
- Accession number :
- edsair.doi.dedup.....40842dfe123b4395f84b97c44e757b1a