Antigen specificity in hydralazine associated ANCA positive systemic vasculitis

QJM. 1995 Nov;88(11):775-83.

Abstract

The anti-hypertensive agent hydralazine can cause a lupus-like syndrome characterized by serosal inflammation, arthralgias and rashes. The kidneys however are usually spared. The condition is characterized by circulating immune complexes and antinuclear antibodies, whilst antibodies against double-stranded DNA are rare. Hydralazine can also cause a systemic vasculitis with a pauci-immune rapidly progressive glomerulonephritis, which is associated with autoantibodies directed against components of the neutrophil cytoplasm. In this study, ten patients with hydralazine-induced vasculitis had antibodies with specificities for both myeloperoxidase and lactoferrin. We suggest that this particular pattern of autoantibodies, together with antibodies with reactivity against nuclear components including double-stranded DNA, are characteristic findings in hydralazine-induced vasculitis. In addition, renal involvement appears to be more common in this group of patients with vasculitis than in those with the lupus-like syndrome.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Antineutrophil Cytoplasmic
  • Antihypertensive Agents / adverse effects*
  • Autoantibodies / blood*
  • Autoantigens / blood*
  • Biomarkers / blood
  • Enzyme-Linked Immunosorbent Assay
  • Epitopes / immunology*
  • Female
  • Humans
  • Hydralazine / adverse effects
  • Lactoferrin / blood
  • Male
  • Middle Aged
  • Peroxidase / blood
  • Retrospective Studies
  • Vasculitis, Leukocytoclastic, Cutaneous / chemically induced
  • Vasculitis, Leukocytoclastic, Cutaneous / immunology*

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Antihypertensive Agents
  • Autoantibodies
  • Autoantigens
  • Biomarkers
  • Epitopes
  • Hydralazine
  • Peroxidase
  • Lactoferrin