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Letter
An unusual case of ANCA positive disease
  1. S Delen1,
  2. A Boonen1,
  3. R Landewé1,
  4. A A Kroon2,
  5. Sj van der Linden1,
  6. J W Cohen Tervaert3
  1. 1Department of Internal Medicine, Division of Rheumatology, University Hospital Maastricht, The Netherlands
  2. 2Department of Internal Medicine, Division of Vascular Medicine, University Hospital Maastricht, The Netherlands
  3. 3Department of Internal Medicine, Division of Clinical and Experimental Immunology, University Hospital Maastricht, The Netherlands
  1. Correspondence to:
    Dr A Boonen, Department of Internal Medicine, Division of Rheumatology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands;
    aboo{at}sint.azm.nl

https://doi.org/10.1136/ard.62.8.780

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    We report here on a patient in whom induction of myeloperoxidase-antineutrophil cytoplasmic antibodies (MPO-ANCA) occurred simultaneously with the development of pseudovasculitis due to the cholesterol emboli syndrome.

    CASE REPORT

    A 65 year old woman was admitted in August 2001 because of fatigue, weight loss, and oligoarthritis. She had a history of hypertension for which she was treated with captopril and hydrochlorothiazide. On examination she had acrocyanosis, livedo reticularis, a blood pressure of 220/110 on both arms, vascular bruits over the carotid and femoral arteries, and arthritis of the right wrist and both knees. The erythrocyte sedimentation rate (ESR) was 70 mm/1st h, C reactive protein (CRP) 75 mg/l, haemoglobin 7.1 mmol/l, and white blood cell count 10.8×109/l. Serum creatinine was normal and there were no abnormalities on urine analysis. Rheumatoid factor, antinuclear antibodies, ANCA, cryoglobulins, and anticardiolipin antibodies tested negative. Systemic vasculitis …

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