%0 Journal Article
%T Anti-neutrophil cytoplasmic antibodies in rheumatoid arthritis: two case reports and review of literature
%A Spoerl David
%A Pers Yves-Marie
%A Jorgensen Christian
%J Allergy, Asthma & Clinical Immunology
%D 2012
%I BioMed Central
%R 10.1186/1710-1492-8-19
%X Background Anti-neutrophil cytoplasmic antibodies are typically detected in anti-neutrophil cytoplasmic antibody associated vasculitis, but are also present in a number of chronic inflammatory non-vasculitic conditions like rheumatoid arthritis. Rare cases of granulomatosis with polyangiitis (formerly known as WegenerĄ¯s granulomatosis, a vasculitic disorder frequently associated with the presence of anti-neutrophil cytoplasmic antibodies) in patients with rheumatoid arthritis have been described in literature. Case presentation We report two middle-aged female patients with rheumatoid arthritis who developed anti-neutrophil cytoplasmic antibodies and symptoms reminiscent of granulomatosis with polyangiitis. Despite the lack of antibodies specific for proteinase 3 and the absence of a classical histology, we report a probable case of granulomatosis with polyangiitis in the first patient, and consider rheumatoid vasculitis in the second patient. Conclusion Taken together with previous reports, these cases highlight that anti-neutrophil cytoplasmic antibodies have to be evaluated very carefully in patients with rheumatoid arthritis. In this context, anti-neutrophil cytoplasmic antibodies detected by indirect immunofluorescence appear to have a low diagnostic value for granulomatosis with polyangiitis. Instead they may have prognostic value for assessing the course of rheumatoid arthritis.
%K Granulomatosis with polyangiitis
%K Rheumatoid arthritis
%K ANCA associated vasculitis
%K Rheumatoid vasculitis
%U http://www.aacijournal.com/content/8/1/19