Antineutrophil-cytoplasmic Autoantibodies (ANCA) in Children with Some Glomerular Disorders Antineutrophil-cytoplasmic Autoantibodies (ANCA) in Children with Some Glomerular Disorders
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Antineutrophil-cytoplasmic autoantibodies (ANCA) are important serological markers for the primary systemic vasculitidis. Two groups of patients were enrolled in this study, group I included 30 children with acute poststreptococcal glomerulonephritis and group 2 included 30 children with corticosteroid-responsive nephrotic syndrome. Sera from all patients were tested for the presence of ANCA using indirect immunofluorescence assay on ethanol fixed normal human neutrophils. We have found that 6 out of 30 patients (20%) in group I were ANCA positive, and 4 out of 30 patients (13%) in group 2 were ANCA positive. The presence of ANCA was significantly associated with a more severe glomerular disease as assessed by serum creatinine level in group I and proteinuria in group 2. Longitudinal studies performed on ANCA positive patients, showed persistence of the phenomenon in all positive patients in group 1 for up to 2 months while there was a seroconversion in 3 out of the 4 ANCA positive patients in group 2. This may reflect the role of corticosteriod therapy in group 2. We concluded that the presence of ANCA in acute poststreptococcal glomerulonephritis and corticosteroidresponsive nephrotic syndrome may have a role in their pathogenesis and may be used as a prognostic marker. We recommend further studies with long-term follow up and renal biopsies to confirm the role of ANCA as a prognostic marker.