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2016 ; 8
(6
): 1306-15
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Diagnostic value of antineutrophil cytoplasmic antibodies in children with
bronchiolitis obliterans
#MMPMID27293851
Chen D
; Xie N
; Lin Y
; Yang Z
; Liu W
; Wu S
; Chen J
; Pan X
; Yang S
; Cai Y
J Thorac Dis
2016[Jun]; 8
(6
): 1306-15
PMID27293851
show ga
BACKGROUND: Diagnosis of childhood bronchiolitis obliterans (BO) is difficult
owing to non-specific clinical presentations and limited investigational options.
There is a lack in established serum biomarkers for BO. While the diagnostic
value of antineutrophil cytoplasmic antibodies (ANCAs) has been discussed, little
is known about this in BO. We aimed to investigate the serological profiles of
ANCAs against myeloperoxidase (MPO-ANCA) and proteinase-3 (PR3-ANCA) in BO and
acute pneumonia. METHODS: In this study, 42 BO children (BO group) and 43 with
mild acute pneumonia (pneumonia group) were included, based on rigorous
diagnostic criteria and additional constraints for minimizing selection bias.
Serum MPO-ANCA and PR3-ANCA levels were measured on the first (baseline) and the
last day of hospitalization (on discharge) by enzyme linked immunosorbent assay.
RESULTS: Although the BO children had a longer hospital stay, the overall rate of
positivity (?180 AAU/mL) and median serum level of MPO-ANCA were higher in the BO
group compared with the pneumonia group, either at baseline (69.1% vs. 9.3%,
292.00 vs. 104.75 AAU/mL, both P<0.001) or on discharge (61.9% vs. 9.3%, 310.50
vs. 95.42 AAU/mL). Similar was found for PR3-ANCA (38.1% vs. 4.7%, 106.66 vs.
54.56 AAU/mL at baseline; 35.7% vs. 2.3%, 97.98 vs. 57.23 AAU/mL on discharge,
both P<0.001). There were a higher rate of dual-positivity and a lower rate of
dual-negativity to both ANCAs in the BO group than those in the pneumonia group
(all P<0.001). CONCLUSIONS: Detection of MPO- and PR3-ANCA can help diagnosis of
childhood BO.