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  • Title: Antineutrophil cytoplasmic antibodies in reactive arthritis.
    Author: Locht H, Peen E, Skogh T.
    Journal: J Rheumatol; 1995 Dec; 22(12):2304-6. PubMed ID: 8835566.
    Abstract:
    OBJECTIVE: To study the occurrence of antineutrophil cytoplasmic antibodies (ANCA) in reactive arthritis (ReA). METHODS: Sera from 22 patients with ReA were analyzed by ELISA for the presence of autoantibodies (IgG and IgA) against a proteinase-3 containing azurophilic granule extract ("alpha-antigen") from human polymorphonuclear leukocytes, myeloperoxidase (MPO), and lactoferrin (Lf), respectively. Rheumatoid factor (RF), antinuclear antibodies (ANA), and HLA-B27 were also tested. Erythrocyte sedimentation rate and serum levels of C-reactive protein were used to assess disease activity. The patients were divided into acute or chronic (> 1 year) disease. RESULTS: 12/22 patients (55%) had IgG ANCA (7 had MPO ANCA, 8 had Lf ANCA, and 4 had alpha-ANCA). Eight patients (36%) had IgA ANCA. One serum was positive only for IgA ANCA. 18/21 patients (86%) were HLA-B27 positive, and none had RF or ANA. The triggering infection was Chlamydia trachomatis in 6 cases. Campylobacter jejuni in 6, Yersinia enterocolitica in 4. In 6 patients the causative microorganism could not be determined. ANCA was more prevalent in chronic disease (6/7, 82%) compared to acute (7/15, 47%). No obvious correlation was seen between ANCA and disease activity. CONCLUSION: ANCA, predominantly those reacting with Lf and/or MPO preparations, are common in ReA.
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