Various Forms of Life in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis
Authors: Susan L. Hogan, Ronald J. Falk, Patrick H. Nachman, J. Charles Jennette
Journal: Annals of Internal Medicine (2006)

Letters7 March 2006Various Forms of Life in Antineutrophil Cytoplasmic Antibody–Associated VasculitisSusan L. Hogan, PhD, MPH, Ronald J. Falk, MD, Patrick H. Nachman, MD, and J. Charles Jennette, MDSusan L. Hogan, PhD, MPHFrom the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Search for more papers by this author, Ronald J. Falk, MDFrom the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Search for more papers by this author, Patrick H. Nachman, MDFrom the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Search for more papers by this author, and J. Charles Jennette, MDFrom the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-144-5-200603070-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We must disagree with some of the concepts described by Hoffman and Langford (1) in their editorial written in response to our evaluation of relapse and treatment resistance in antineutrophil cytoplasmic antibody (ANCA)–associated small-vessel vasculitis (2). The editorial primarily addressed 1) the clinical value of our results given that our cohort was not homogeneous and included patients with small-vessel vasculitis manifesting as Wegener granulomatosis, microscopic polyangiitis, and renal-limited pauci-immune necrotizing glomerulonephritis; 2) the usefulness of our requirement for ANCA seropositivity as the primary classification criterion; and 3) the risks and benefits of prolonged therapy. The authors disagreed ...References1. Hoffman GS, Langford CA. Are there different forms of life in the antineutrophil cytoplasmic antibody universe? [Editorial]. Ann Intern Med. 2005;143:683-5. [PMID: 16263891] LinkGoogle Scholar2. Hogan SL, Falk RJ, Chin H, Cai J, Jennette CE, Jennette JC, et al. Predictors of relapse and treatment resistance in antineutrophil cytoplasmic antibody-associated small-vessel vasculitis. Ann Intern Med. 2005;143:621-31. [PMID: 16263884] LinkGoogle Scholar3. Hunder GG, Arend WP, Bloch DA, Calabrese LH, Fauci AS, Fries JF, et al. The American College of Rheumatology 1990 criteria for the classification of vasculitis. Introduction. Arthritis Rheum. 1990;33:1065-7. [PMID: 2390119] CrossrefMedlineGoogle Scholar4. Jennette JC, Falk RJ, Andrassy K, Bacon PA, Churg J, Gross WL, et al. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum. 1994;37:187-92. [PMID: 8129773] CrossrefMedlineGoogle Scholar5. Bruce IN, Bell AL. A comparison of two nomenclature systems for primary systemic vasculitis. Br J Rheumatol. 1997;36:453-8. [PMID: 9159539] CrossrefMedlineGoogle Scholar6. Falk RJ, Jennette JC. ANCA are pathogenic—oh yes they are! [Editorial]. J Am Soc Nephrol. 2002;13:1977-9. [PMID: 12089397] CrossrefMedlineGoogle Scholar7. Heeringa P, Huugen D, Tervaert JW. Anti-neutrophil cytoplasmic autoantibodies and leukocyte-endothelial interactions: a sticky connection? Trends Immunol. 2005;26:561-4. [PMID: 16139567] CrossrefMedlineGoogle Scholar8. Sable-Fourtassou R, Cohen P, Mahr A, Pagnoux C, Mouthon L, Jayne D, et al. Antineutrophil cytoplasmic antibodies and the Churg-Strauss syndrome. Ann Intern Med. 2005;143:632-8. [PMID: 16263885] LinkGoogle Scholar9. Savige J, Pollock W, Trevisin M. What do antineutrophil cytoplasmic antibodies (ANCA) tell us? Best Pract Res Clin Rheumatol. 2005;19:263-76. [PMID: 15857795] CrossrefMedlineGoogle Scholar10. Eisenberger U, Fakhouri F, Vanhille P, Beaufils H, Mahr A, Guillevin L, et al. ANCA-negative pauci-immune renal vasculitis: histology and outcome. Nephrol Dial Transplant. 2005;20:1392-9. [PMID: 15855209] CrossrefMedlineGoogle Scholar11. De Groot K, Rasmussen N, Bacon PA, Tervaert JW, Feighery C, Gregorini G, et al. Randomized trial of cyclophosphamide versus methotrexate for induction of remission in early systemic antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheum. 2005;52:2461-9. [PMID: 16052573] CrossrefMedlineGoogle Scholar12. Jayne D, Rasmussen N, Andrassy K, Bacon P, Tervaert JW, Dadoniene J, et al. A randomized trial of maintenance therapy for vasculitis associated with antineutrophil cytoplasmic autoantibodies. N Engl J Med. 2003;349:36-44. [PMID: 12840090] CrossrefMedlineGoogle Scholar13. Tesar V, Rihova Z, Jancova E, Rysava R, Merta M. Current treatment strategies in ANCA-positive renal vasculitis—lessons from European randomized trials. Nephrol Dial Transplant. 2003;18 Suppl 5 v2-4. [PMID: 12817056] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAre There Different Forms of Life in the Antineutrophil Cytoplasmic Antibody Universe? Gary S. Hoffman and Carol A. Langford Predictors of Relapse and Treatment Resistance in Antineutrophil Cytoplasmic Antibody–Associated Small-Vessel Vasculitis Susan L. Hogan , Ronald J. Falk , Hyunsook Chin , Jianwen Cai , Caroline E. Jennette , J. Charles Jennette , and Patrick H. Nachman Antineutrophil Cytoplasmic Antibodies and the Churg–Strauss Syndrome Régis Sablé-Fourtassou , Pascal Cohen , Alfred Mahr , Christian Pagnoux , Luc Mouthon , David Jayne , Daniel Blockmans , Jean-François Cordier , Philippe Delaval , Xavier Puechal , Dominique Lauque , Jean-François Viallard , Abdelkader Zoulim , Loïc Guillevin , and Various Forms of Life in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis Gary S. Hoffman and Carol A. Langford Metrics Cited ByPredicament of classification: Multisystem small vessel vasculitis with cresentic GlomerulonephritisGenetic variants in ANCA-associated vasculitis: a meta-analysisEnho Mutations Causing Low Adropin: A Possible Pathomechanism of MPO-ANCA Associated Lung InjuryGenetically Distinct Subsets within ANCA-Associated VasculitisVASCULITIS AND ITS CLASSIFICATIONA Case StudyVasculitis, Neutrophilic Dermatoses and Related DisordersImprovement in Relative Survival of Patients with Vasculitis: Study of 101 Cases Compared to the General PopulationFunctionally relevant variations of the interleukin-10 gene associated with antineutrophil cytoplasmic antibody-negative Churg-Strauss syndrome, but not with Wegener's granulomatosisCurrent World Literature 7 March 2006Volume 144, Issue 5Page: 377-378KeywordsClinical trialsCorticosteroid therapyPathogenesisRenal analysisRenal diseasesRespiratory systemRheumatologySpecificityVasculitisWegener granulomatosis ePublished: 7 March 2006 Issue Published: 7 March 2006 CopyrightCopyright © 2006 by American College of Physicians. 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