Anti-MPO-ANCA-positive microscopic polyangiitis following subacute bacterial endocarditis

Clin Rheumatol. 2001;20(6):441-3. doi: 10.1007/pl00011214.


Although infectious agents such as Staphylococcus aureus have been implicated in the pathogenesis of Wegener's granulomatosis, the role of bacterial infections in the pathogenesis of other types of small-vessel vasculitides associated with antineutrophil cytoplasmic antibodies (ANCA) is less clear. We describe a patient who developed a non-granulomatous necrotising small vessel vasculitis and perinuclear ANCA (p-ANCA) directed against myeloperoxidase (MPO) after recurrent episodes of bacterial endocarditis due to Staph. aureus. Although cytoplasmic ANCA (c-ANCA) directed against proteinase 3 have been reported in single patients with bacterial endocarditis, to our knowledge this patient is the first reported case of an anti-MPO-ANCA positive systemic vasculitis following bacterial endocarditis.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Antineutrophil Cytoplasmic / analysis*
  • Endocarditis, Subacute Bacterial / complications*
  • Humans
  • Male
  • Microcirculation
  • Middle Aged
  • Peroxidase / immunology*
  • Recurrence
  • Staphylococcal Infections / complications*
  • Vasculitis / etiology*
  • Vasculitis / immunology


  • Antibodies, Antineutrophil Cytoplasmic
  • Peroxidase