Diagnosis
IgA antibodies to myeloperoxidase in patients with eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
E. Oommen1, A. Hummel2, L. Allmannsberger3, D. Cuthbertson4, S. Carette5, C. Pagnoux6, G.S. Hoffman7, D.E. Jenne8, N.A. Khalidi9, C.L. Koening10, C.A. Langford11, C.A. Mcalear12, L. Moreland13, P. Seo14, A. Sreih15, S.R. Ytterberg16, P.A. Merkel17, U. Specks18, P.A. Monach19
- Section of Rheumatology, Boston University School of Medicine, Boston, MA; and Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine, Atlanta, GA, USA.
- Division of Pulmonology, Mayo Clinic College of Medicine, Rochester, MN, USA.
- Helmholtz Zentrum Muenchen, Munich, Germany.
- Department of Biostatistics, University of South Florida, FL, USA.
- Division of Rheumatology, Mount Sinai Hospital, Toronto, ON, Canada.
- Division of Rheumatology, Mount Sinai Hospital, Toronto, ON, Canada.
- Center for Vasculitis Care and Research, Cleveland Clinic, Cleveland, OH, USA.
- Helmholtz Zentrum Muenchen, Munich, Germany.
- Division of Rheumatology, St. Joseph’s Healthcare, McMaster University, Hamilton, ON, Canada.
- Division of Rheumatology, University of Utah, Salt Lake City, UT, USA.
- Center for Vasculitis Care and Research, Cleveland Clinic, Cleveland, OH, USA.
- Division of Rheumatology and Clinical Immunology, University of Pennsylvania, Philadelphia, PA, USA.
- Division of Rheumatology, University of Pittsburgh, Pittsburgh, PA, USA.
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA.
- Division of Rheumatology and Clinical Immunology, University of Pennsylvania, Philadelphia, PA, USA.
- Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN, USA.
- Division of Rheumatology and Clinical Immunology, University of Pennsylvania, Philadelphia, PA, USA.
- Division of Pulmonology, Mayo Clinic College of Medicine, Rochester, MN, USA.
- Section of Rheumatology, Boston University School of Medicine; and Rheumatology Section, VA Boston Healthcare System, Boston, MA, USA. pmonach@bu.edu
for the Vasculitis Clinical Research Consortium
CER9838
2017 Vol.35, N°1 ,Suppl.103
PI 0098, PF 0101
Diagnosis
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PMID: 28281453 [PubMed]
Received: 09/08/2016
Accepted : 06/12/2016
In Press: 01/03/2017
Published: 20/04/2017
Abstract
OBJECTIVES:
To determine the prevalence of anti-myeloperoxidase (MPO) antibodies of IgA (IgA anti-MPO) isotype in patients with eosinophilic granulomatosis with polyangiitis (EGPA), and the association of the IgA antibodies with IgG anti-MPO and with disease activity.
METHODS:
Serum samples from patients with EGPA followed in a multicenter longitudinal cohort were tested by ELISA for the presence of IgA anti-MPO and IgG anti-MPO antibodies. Sera from 87 healthy controls were used to define a positive test. Sera from 168 patients with EGPA (298 samples) were tested. Frequencies of positive testing for IgA anti-MPO were compared between patients with active EGPA, patients in remission, and controls.
RESULTS:
IgA anti-MPO was detected in 10 of 168 (6%) patients with EGPA (11 of 298 serum samples) compared to 1 of 87 (1%) healthy controls (p=0.10). All 11 samples testing positive for IgA anti-MPO also tested positive for IgG anti-MPO. Ninety samples tested positive for IgG anti-MPO but negative for IgA. Samples taken during active EGPA were positive for IgA anti-MPO in 6/72 cases (8%), compared to 5/226 (2%) during remission (p=0.03). Among samples taken during moderate or high disease activity, 5/41 were positive (12%, p=0.01 compared to remission).
CONCLUSIONS:
Although IgA anti-MPO antibodies are detectable in some patients with EGPA and may be detectable more frequently during active disease, their presence seems unlikely to provide information beyond what is obtained from conventional IgG anti-MPO.
