medicina59巻8号

2022年07月発行

特集 日常診療に潜む臨床検査のピットフォールを回避せよ 各論 ＜免疫学的検査＞

Case 15．ANCA陽性！それって本当に血管炎？

著者： 三澤美和¹

所属機関： ¹大阪医科薬科大学病院総合診療科

ページ範囲：P.1278 - P.1282

症例
70代男性
主　訴　発熱，食欲不振，全身倦怠感

参考文献

1）Kitching AR, et al：ANCA-associated vasculitis. Nat Rev Dis Primers 6：71, 2020

2）Guchelaar NAD, et al：The value of anti-neutrophil cytoplasmic antibodies（ANCA）testing for the diagnosis of ANCA-associated vasculitis, a systematic review and meta-analysis. Autoimmunity Reviews 20：102716, 2021

3）Weidemann, et al：ANCA in haemodialysis patients. Nephrol Dial Transplant 8：839-845, 1993

4）Tsiveriotis K, et al：Antineutrophil cytoplasmic antibodies testing in a large cohort of unselected greek patients. Autoimmune Dis 2011：626495, 2011

5）Hagen EC, et al：Diagnostic value of standardized assays for anti-neutrophil cytoplasmic antibodies in idiopathic systemic vasculitis. EC/BCR Project for ANCA Assay Standardization. Kidney Int 53：743-53, 1998

6）Prüβmann J, et al：Co-occurrence of autoantibodies in healthy blood donors. Exp Dermatol 23：519-521, 2014

7）Bosch X, et al：Antineutrophil cytoplasmic antibodies. Lancet 368：404-418, 2006

8）萩野　昇（編）：ケースでわかるリウマチ・膠原病診療ハンドブック—的確な診断と上手なフォローのための臨床パール．p 312，羊土社，2021

9）Sinclair D, et al：The effect of a symptom related “gating policy” on ANCA requests in routine clinical practice. J Clin Pathol 57：131-134, 2004

10）Sinico RA, Radice A：Antineutrophil cytoplasmic antibodies（ANCA）testing；Detection methods and clinical application. Clin Exp Rheumatol 32（Suppl 82）：S112-S117, 2014

11）Langlois V, et al：Antineutrophil cytoplasmic antibodies associated with infective endocarditis. Medicine（Baltimore）95：e2564, 2016

12）Houden E, et al：Diagnosing ANCA-associated vasculitis in ANCA positive patients；A retrospective analysis on the role of clinical symptoms and the ANCA titre. Medicine（Baltimore）95：e5096, 2004