Skip to main content
Top
Published in: Rheumatology International 5/2006

01-03-2006 | Case Report

Scleroderma associated with ANCA-associated vasculitis

Authors: Young Hee Rho, Seong Jae Choi, Young Ho Lee, Jong Dae Ji, Gwan Gyu Song

Published in: Rheumatology International | Issue 5/2006

Login to get access

Abstract

Scleroderma and ANCA-associated vasculitides (AAV), such as microscopic polyangiitis, are distinct disease entities, but are rarely known to coexist with each other. We have reported on two cases of scleroderma patients for the first time in Korea, and these patients were initially known to have only limited type scleroderma with pulmonary fibrosis, but eventually they were found to be ANCA-positive with the associated clinical features of vasculitis. Both were treated with high-dose steroids and cyclophosphamide and remitted without major sequelae. When scleroderma patients exhibit atypical features such as normotensive renal failure with signs of active inflammation, the possibility of AAV should always be considered.
Literature
1.
go back to reference Endo H, Hosono T, Kondo H (1994) Antineutrophil cytoplasmic autoantibodies in 6 patients with renal failure and systemic sclerosis. J Rheumatol 21:864–870PubMed Endo H, Hosono T, Kondo H (1994) Antineutrophil cytoplasmic autoantibodies in 6 patients with renal failure and systemic sclerosis. J Rheumatol 21:864–870PubMed
2.
go back to reference Steen VD, Costantino JP, Shapiro AP, Medsger TA Jr (1990) Outcome of renal crisis in systemic sclerosis: relation to availability of angiotensin converting enzyme (ACE) inhibitors. Ann Intern Med 113:352–357PubMed Steen VD, Costantino JP, Shapiro AP, Medsger TA Jr (1990) Outcome of renal crisis in systemic sclerosis: relation to availability of angiotensin converting enzyme (ACE) inhibitors. Ann Intern Med 113:352–357PubMed
3.
go back to reference Steen VD, Medsger TA Jr (1998) Case-control study of corticosteroids and other drugs that either precipitate or protect from the development of scleroderma renal crisis. Arthritis Rheum 41:1613–1619PubMedCrossRef Steen VD, Medsger TA Jr (1998) Case-control study of corticosteroids and other drugs that either precipitate or protect from the development of scleroderma renal crisis. Arthritis Rheum 41:1613–1619PubMedCrossRef
5.
go back to reference Katrib A, Sturgess A, Bertouch JV (1999) Systemic sclerosis and antineutrophil cytoplasmic autoantibody-associated renal failure. Rheumatol Int 19:61–63PubMedCrossRef Katrib A, Sturgess A, Bertouch JV (1999) Systemic sclerosis and antineutrophil cytoplasmic autoantibody-associated renal failure. Rheumatol Int 19:61–63PubMedCrossRef
6.
go back to reference Casari S, Haeney M, Farrand S, Herrick A (2002) Antineutrophil cytoplasmic antibodies a “Red Flag” in patients with systemic sclerosis. J Rheumatol 29:2666–2667PubMed Casari S, Haeney M, Farrand S, Herrick A (2002) Antineutrophil cytoplasmic antibodies a “Red Flag” in patients with systemic sclerosis. J Rheumatol 29:2666–2667PubMed
7.
go back to reference Omote A, Muramatsu M, Sugimoto Y, Hosono S, Murakami R, Tanaka H et al (1997) Myeloperoxidase-specific anti-neutrophil cytoplasmic autoantibodies – related scleroderma renal crisis treated with double-filtration plasmapheresis. Intern Med 36:508–513PubMedCrossRef Omote A, Muramatsu M, Sugimoto Y, Hosono S, Murakami R, Tanaka H et al (1997) Myeloperoxidase-specific anti-neutrophil cytoplasmic autoantibodies – related scleroderma renal crisis treated with double-filtration plasmapheresis. Intern Med 36:508–513PubMedCrossRef
8.
go back to reference Homma S, Matsushita H, Nakata K (2004) Pulmonary fibrosis in myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitides. Respirology 9:190–196PubMedCrossRef Homma S, Matsushita H, Nakata K (2004) Pulmonary fibrosis in myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitides. Respirology 9:190–196PubMedCrossRef
9.
go back to reference Lhote F, Cohen P, Genereau T, Gayraud M, Guillevin L (1996) Microscopic polyangiitis: clinical aspects and treatment. Ann Med Interne (Paris) 147:165–177 Lhote F, Cohen P, Genereau T, Gayraud M, Guillevin L (1996) Microscopic polyangiitis: clinical aspects and treatment. Ann Med Interne (Paris) 147:165–177
10.
go back to reference Gaudin PB, Askin FB, Falk RJ, Jennette JC (1995) The pathologic spectrum of pulmonary lesions in patients with anti-neutrophil cytoplasmic autoantibodies specific for anti-proteinase 3 and anti-myeloperoxidase. Am J Clin Pathol 104:7–16PubMed Gaudin PB, Askin FB, Falk RJ, Jennette JC (1995) The pathologic spectrum of pulmonary lesions in patients with anti-neutrophil cytoplasmic autoantibodies specific for anti-proteinase 3 and anti-myeloperoxidase. Am J Clin Pathol 104:7–16PubMed
11.
go back to reference Nada AK, Torres VE, Ryu JH, Lie JT, Holley KE (1990) Pulmonary fibrosis as an unusual clinical manifestation of a pulmonary-renal vasculitis in elderly patients. Mayo Clin Proc 65:847–856PubMed Nada AK, Torres VE, Ryu JH, Lie JT, Holley KE (1990) Pulmonary fibrosis as an unusual clinical manifestation of a pulmonary-renal vasculitis in elderly patients. Mayo Clin Proc 65:847–856PubMed
12.
go back to reference Eschun GM, Mink SN, Sharma S (2003) Pulmonary interstitial fibrosis as a presenting manifestation in perinuclear antineutrophilic cytoplasmic antibody microscopic polyangiitis. Chest 123:297–301PubMedCrossRef Eschun GM, Mink SN, Sharma S (2003) Pulmonary interstitial fibrosis as a presenting manifestation in perinuclear antineutrophilic cytoplasmic antibody microscopic polyangiitis. Chest 123:297–301PubMedCrossRef
13.
go back to reference Ruffatti A, Sinico RA, Radice A, Ossi E, Cozzi F, Tonello M et al (2002) Autoantibodies to proteinase 3 and myeloperoxidase in systemic sclerosis. J Rheumatol 29:918–923PubMed Ruffatti A, Sinico RA, Radice A, Ossi E, Cozzi F, Tonello M et al (2002) Autoantibodies to proteinase 3 and myeloperoxidase in systemic sclerosis. J Rheumatol 29:918–923PubMed
14.
go back to reference Kiraz S, Simsek H, Ertenli I, Benekli M, Kadayifci A (1996) Antineutrophil cytoplasmic antibodies in systemic sclerosis. Clin Rheumatol 15:519–520PubMedCrossRef Kiraz S, Simsek H, Ertenli I, Benekli M, Kadayifci A (1996) Antineutrophil cytoplasmic antibodies in systemic sclerosis. Clin Rheumatol 15:519–520PubMedCrossRef
15.
go back to reference Caramaschi P, Biasi D, Tonolli E, Carletto A, Bambara LM (2002) Antineutrophil cytoplasmic antibodies in scleroderma patients: first report of a case with anti-proteinase 3 antibodies and review of the literature. Joint Bone Spine 69:177–180PubMedCrossRef Caramaschi P, Biasi D, Tonolli E, Carletto A, Bambara LM (2002) Antineutrophil cytoplasmic antibodies in scleroderma patients: first report of a case with anti-proteinase 3 antibodies and review of the literature. Joint Bone Spine 69:177–180PubMedCrossRef
16.
go back to reference Khanna D, Aggarwal A, Bhakuni DS, Dayal R, Misra R (2003) Bactericidal/permeability-increasing protein and cathepsin G are the major antigenic targets of antineutrophil cytoplasmic autoantibodies in systemic sclerosis. J Rheumatol 30:1248–1252PubMed Khanna D, Aggarwal A, Bhakuni DS, Dayal R, Misra R (2003) Bactericidal/permeability-increasing protein and cathepsin G are the major antigenic targets of antineutrophil cytoplasmic autoantibodies in systemic sclerosis. J Rheumatol 30:1248–1252PubMed
Metadata
Title
Scleroderma associated with ANCA-associated vasculitis
Authors
Young Hee Rho
Seong Jae Choi
Young Ho Lee
Jong Dae Ji
Gwan Gyu Song
Publication date
01-03-2006
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 5/2006
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-005-0003-5

Other articles of this Issue 5/2006

Rheumatology International 5/2006 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.