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Korean J Nephrol. 2008 Jul;27(4):476-480. Korean. Case Report.
Choi JH , Jung DE , Ryu HS , Kim HJ , Lee YM , Lee JH , Lee JE , Shin JH , Song JH , Ahn SH .
Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.

Antineutrophil cytoplasmic antibodies (ANCA) directed against either proteinase-3 or myeloperoxidase are associated with a limited group of small vessel vasculitic syndromes. C-ANCA is regarded as highly specific for idiopathic ANCA-associated vasculitis (AAV). However, C-ANCA is not specific for Wegeners granulomatosis and has been reported in the course of a variety of infectious conditions. Sub-acute bacterial endocarditis is a notable concern because it may be associated with C-ANCA. The misdiagnosis of bacterial endocarditis as AAV and the administration of immunosuppressive treatment could aggravate the infection. We describe a patient with sub-acute bacterial endocarditis who presented with features mimicking vasculitis and positive C-ANCA by indirect immunofluorescence and for anti-PR3 antibodies by antigen-specific ELISA.

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