Association of IgM with IgG ANCA in patients presenting with pulmonary hemorrhage

V. L.M. Esnault, Behzad Soleimani, M. T. Keogan, A. A. Brownlee, D. R.W. Jayne, C. M. Lockwood

Research output: Contribution to journalArticle

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Abstract

ANCA are markers for systemic vasculitis such as Wegener's granulomatosis (WG) and microscopic polyarteritis (MPA) and are usually of the IgG isotype. However, IgM ANCA may rarely occur in isolation, and in these circumstances, we have found that they are associated clinically with a syndrome of pulmonary hemorrhage and systemic vasculitis. How frequently IgM ANCA may occur in conjunction with IgG has not previously been investigated. We report here a study of 24 consecutive patients with IgG ANCA-positive systemic vasculitis (14 WG, 10 MPA) in whom we determined whether IgM ANCA occurred in association with IgG ANCA, and if so, whether this had clinical importance. Eight patients were found to have IgM ANCA as well as IgG ANCA, and of these, seven presented with severe pulmonary hemorrhage. None of the IgM ANCA-negative patients presented with pulmonary hemorrhage. Although the occurrence of pulmonary hemorrhage in ANCA positive vasculitis was closely correlated with the presence of IgM ANCA, the antigen specificity of these IgM autoantibodies was variable, since both myeloperoxidase (4 patients), PR3 (3 patients), and an unknown ANCA antigen (1 patient) were found to be targets. We conclude that knowledge of ANCA isotype may have important clinical and therapeutic implications for the management of patients with systemic vasculitis.

Original languageEnglish (US)
Pages (from-to)1304-1310
Number of pages7
JournalKidney International
Volume41
Issue number5
DOIs
StatePublished - Jan 1 1992

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Antineutrophil Cytoplasmic Antibodies
Immunoglobulin M
Immunoglobulin G
Hemorrhage
Lung
Systemic Vasculitis
Granulomatosis with Polyangiitis
Antigens
Vasculitis
Autoantibodies
Peroxidase

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Esnault, V. L. M., Soleimani, B., Keogan, M. T., Brownlee, A. A., Jayne, D. R. W., & Lockwood, C. M. (1992). Association of IgM with IgG ANCA in patients presenting with pulmonary hemorrhage. Kidney International, 41(5), 1304-1310. https://doi.org/10.1038/ki.1992.194
Esnault, V. L.M. ; Soleimani, Behzad ; Keogan, M. T. ; Brownlee, A. A. ; Jayne, D. R.W. ; Lockwood, C. M. / Association of IgM with IgG ANCA in patients presenting with pulmonary hemorrhage. In: Kidney International. 1992 ; Vol. 41, No. 5. pp. 1304-1310.
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Esnault, VLM, Soleimani, B, Keogan, MT, Brownlee, AA, Jayne, DRW & Lockwood, CM 1992, 'Association of IgM with IgG ANCA in patients presenting with pulmonary hemorrhage', Kidney International, vol. 41, no. 5, pp. 1304-1310. https://doi.org/10.1038/ki.1992.194

Association of IgM with IgG ANCA in patients presenting with pulmonary hemorrhage. / Esnault, V. L.M.; Soleimani, Behzad; Keogan, M. T.; Brownlee, A. A.; Jayne, D. R.W.; Lockwood, C. M.

In: Kidney International, Vol. 41, No. 5, 01.01.1992, p. 1304-1310.

Research output: Contribution to journalArticle

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AU - Esnault, V. L.M.

AU - Soleimani, Behzad

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