Abstract Objective To study the value of anti-neutrophil cytoplasmic antibody (ANCA) in assessing the severity of bronchiolitis obliterans (BO) in children. Methods A prospective analysis was performed on 59 children who were diagnosed with BO from June 2009 to October 2014. ELISA was used to measure the concentrations of myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA in serum. According to the results of ELISA, the children were divided into three groups:double-negative ANCA (n=22), single-positive ANCA (n=17), and double-positive ANCA (n=20). The three groups were compared in terms of the scores of BO risk factors, clinical symptoms, chest high-resolution computed tomography (HRCT), and lung pathology on admission, as well as the changes in the expression level of ANCA and the scores of clinical symptoms and chest HRCT over time. Results Compared with the double-negative ANCA group, the double-positive ANCA group had a significantly higher score of BO risk factors (P < 0.05), and the single-positive ANCA group and the double-positive ANCA group had significantly higher scores of clinical symptoms, chest HRCT, and lung pathology (P < 0.05). The children were followed up for 6 months after discharge, and there were significant reductions in MPO-ANCA and PR3-ANCA titers from admission and discharge to the end of follow-up (P < 0.05), as well as a significant reduction in the score of clinical symptoms from admission to the end of follow-up (P < 0.05), while there was no significant change in the score of chest HRCT from admission to the end of follow-up (P > 0.05). The single-positive ANCA and double-positive ANCA groups still had a significantly higher score of clinical symptoms than the double-negative ANCA group (P < 0.05). Conclusions The expression level of ANCA is correlated with the severity of BO in children and thus has certain clinical significance in disease evaluation.
CHEN Xiao-Wen,CHEN De-Hui,WU Shang-Zhi et al. Value of anti-neutrophil cytoplasmic antibody in assessing the severity of bronchiolitis obliterans in children[J]. CJCP, 2020, 22(9): 990-995.
CHEN Xiao-Wen,CHEN De-Hui,WU Shang-Zhi et al. Value of anti-neutrophil cytoplasmic antibody in assessing the severity of bronchiolitis obliterans in children[J]. CJCP, 2020, 22(9): 990-995.
Jerkic SP, Brinkmann F, Calder A, et al. Postinfectious bronchiolitis obliterans in children:diagnostic workup and therapeutic options:a workshop report[J]. Can Respir J, 2020, 2020:5852827.
[2]
Yu J. Postinfectious bronchiolitis obliterans in children:lessons from bronchiolitis obliterans after lung transplantation and hematopoietic stem cell transplantation[J]. Korean J Pediatr, 2015, 58(12):459-465.
[3]
Suwanchote S, Rachayon M, Rodsaward P, et al. Anti-neutrophil cytoplasmic antibodies and their clinical significance[J]. Clin Rheumatol, 2018, 37(4):875-884.
[4]
Nakazawa D, Masuda S, Tomaru U, et al. Pathogenesis and therapeutic interventions for ANCA-associated vasculitis[J]. Nat Rev Rheumatol, 2019, 15(2):91-101.
[5]
Smith ML. Pathology of antineutrophil cytoplasmic antibody-associated pulmonary and renal disease[J]. Arch Pathol Lab Med, 2017, 141(2):223-231.
[6]
Borie R, Crestani B. Antineutrophil cytoplasmic antibody-associated lung fibrosis[J]. Semin Respir Crit Care Med, 2018, 39(4):465-470.
[7]
Hozumi H, Enomoto N, Oyama Y, et al. Clinical implication of proteinase-3-antineutrophil cytoplasmic antibody in patients with idiopathic interstitial pneumonias[J]. Lung, 2016, 194(2):235-242.
[8]
Chen D, Xie N, Lin Y, et al. Diagnostic value of antineutrophil cytoplasmic antibodies in children with bronchiolitis obliterans[J]. J Thorac Dis, 2016, 8(6):1306-1315.
Murtagh P, Giubergia V, Viale D, et al. Lower respiratory infections by adenovirus in children. Clinical features and risk factors for bronchiolitis obliterans and mortality[J]. Pediatr Pulmonol, 2009, 44(5):450-456.
[11]
Korppi M, Kuikka L, Reijonen T, et al. Bronchial asthma and hyperreactivity after early childhood bronchiolitis or pneumonia. An 8-year follow-up study[J]. Arch Pediatr Adolesc Med, 1994, 148(10):1079-1084.
Moonnumakal SP, Fan LL. Bronchiolitis obliterans in children[J]. Curr Opin Pediatr, 2008, 20(3):272-278.
[16]
Konen E, Gutierrez C, Chaparro C, et al. Bronchiolitis obliterans syndrome in lung transplant recipients:can thin-section CT findings predict disease before its clinical appearance?[J]. Radiology, 2004, 231(2):467-473.
[17]
Mauad T, Dolhnikoff M, São Paulo Bronchiolitis Obliterans Study Group. Histology of childhood bronchiolitis obliterans[J]. Pediatr Pulmonol, 2002, 33(6):466-474.
Yates M, Watts RA, Bajema IM, et al. EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis[J]. Ann Rheum Dis, 2016, 75(9):1583-1594.
[20]
Arman F, Barsoum M, Selamet U, et al. Antineutrophil cytoplasmic antibody-associated vasculitis, update on molecular pathogenesis, diagnosis, and treatment[J]. Int J Nephrol Renovasc Dis, 2018, 11:313-319.
