Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Maaten, J. C. t.
Right arrow Articles by Hoorntje, S. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Maaten, J. C. t.
Right arrow Articles by Hoorntje, S. J.
(Chest. 1996;110:357-362.)
© 1996 American College of Chest Physicians

Respiratory Failure in ANCA-Associated Vasculitis

Jan C. ter Maaten MD1; Casper F.M. Franssen MD1; Reinold O.B. Gans MD1; Robert J.M. Strack van Schijndel MD1; and Steven J. Hoorntje MD1

1 From the Departments of Medicine, Catharina Hospital, Eindhoven and University Hospital Vrije Univesiteit, Amsterdam, the Netherlands

Objective: To assess the prevalence, clinical manifestations, and course of respiratory failure in all patients who tested positive for antineutrophil cytoplasmic autoantibodies (ANCA) in our clinics in the period between January 1985 and January 1993.

Design: Case-series analysis.

Setting: Three teaching hospitals in the Netherlands.

Patients: Two hundred twenty consecutive patients suspected of having vasculitis and/or glomerulonephritis who tested positive for ANCA by indirect immunofluorescence and enzyme-linked immunosorbent assay.

Results: Sixty-two patients had pulmonary involvement. Acute respiratory failure developed in nine. Respiratory failure was related to infections in two of them and to ANCA-associated vasculitis in seven. These seven patients uniformly presented with pulmonary hemorrhage and diffuse pulmonary infiltrates. The diagnosis of systemic vasculitis was supported by the presence of a pulmonaryrenal syndrome in all patients, and by detection of antibodies to the proteinase 3 or myeloperoxidase antigen in all but one patient. Antiglomerular basement membrane antibodies were absent. The mortality was high due to hypoxic respiratory failure, pulmonary superinfections, and concomitant renal failure.

Conclusions: Acute respiratory failure due to vasculitis developed in one of every nine patients with ANCA-associated pulmonary disease. Patients usually present with pulmonary infiltrates and hemoptysis. A diagnosis of vasculitis may be further supported by analysis of the urinary sediment and determination of the ANCA target antigen. It remains to be proved that early detection of ANCA favorably affects the outcome.

Key Words: acute respiratory failure • antineutrophil cytoplasmic autoantibodies • vasculitis

Submitted on August 23, 1995
Accepted on January 19, 1996




This article has been cited by other articles:


Home page
 ThoraxHome page
M. I Schwarz and K. K Brown
Rare diseases bullet 10: Small vessel vasculitis of the lung
Thorax, June 1, 2000; 55(6): 502 - 510.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1996 by the American College of Chest Physicians.