Pulse Versus Daily Oral Cyclophosphamide in ANCA-Associated Vasculitis
Authors: Lorraine Harper
Journal: Annals of Internal Medicine (2010)

Letters5 January 2010Pulse Versus Daily Oral Cyclophosphamide in ANCA-Associated VasculitisLorraine Harper, MD, PhD, Kirsten de Groot, MD, and Caroline O. Savage, MD, PhDLorraine Harper, MD, PhDFrom Klinikum Offenbach GmbH, 63069 Offenbach/Main, Germany; and University of Birmingham, Edgbaston B15 2TT, United Kingdom.Search for more papers by this author, Kirsten de Groot, MDFrom Klinikum Offenbach GmbH, 63069 Offenbach/Main, Germany; and University of Birmingham, Edgbaston B15 2TT, United Kingdom.Search for more papers by this author, and Caroline O. Savage, MD, PhDFrom Klinikum Offenbach GmbH, 63069 Offenbach/Main, Germany; and University of Birmingham, Edgbaston B15 2TT, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-1-201001050-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate our colleagues' comments and are glad that our analysis has stimulated further thought among clinicians. We agree with Dr. Padhan that Wegener granulomatosis may be difficult to differentiate from tuberculous infection. However, studies suggest that the presence of both positive cytoplasmic ANCA by immunofluorescence and proteinase 3 enzyme-linked immunosorbent assay has a low prevalence in tuberculosis (1). Even in those rare patients in whom the diagnosis of Wegener granulomatosis is doubted and the balance of evidence favors ANCA-associated vasculitis, we believe that patients should be treated with pulse cyclophosphamide rather than with daily oral cyclophosphamide. The ...Reference1. Teixeira L, Mahr A, Jaureguy F, Noël LH, Nunes H, Lefort A, et al. Low seroprevalence and poor specificity of antineutrophil cytoplasmic antibodies in tuberculosis. Rheumatology (Oxford). 2005;44:247-50. [PMID: 15546964] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Klinikum Offenbach GmbH, 63069 Offenbach/Main, Germany; and University of Birmingham, Edgbaston B15 2TT, United Kingdom.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPulse Versus Daily Oral Cyclophosphamide for Induction of Remission in Antineutrophil Cytoplasmic Antibody—Associated Vasculitis Kirsten de Groot , Lorraine Harper , David R.W. Jayne , Luis Felipe Flores Suarez , Gina Gregorini , Wolfgang L. Gross , Rashid Luqmani , Charles D. Pusey , Niels Rasmussen , Renato A. Sinico , Vladimir Tesar , Philippe Vanhille , Kerstin Westman , Caroline O.S. Savage , and Pulse Versus Daily Oral Cyclophosphamide in ANCA-Associated Vasculitis Prasanta Padhan Pulse Versus Daily Oral Cyclophosphamide in ANCA-Associated Vasculitis Lee A. Hebert and Brad H. Rovin Pulse Versus Daily Oral Cyclophosphamide in ANCA-Associated Vasculitis Stuart M. Levine Metrics 5 January 2010Volume 152, Issue 1Page: 65KeywordsCyclophosphamideHeart rateProteinuriaRenal analysisRenal failureSafetyToxicityVasculitisWegener granulomatosis ePublished: 5 January 2010 Issue Published: 5 January 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...