AN ASSOCIATION BETWEEN ANCA POSITIVE RENAL-DISEASE AND MALIGNANCY

The detection of anti-neutrophil cytoplasmic antiodies (ANCA) is now a routine part of the evaluation of patients clinically suspected of su ffering from small vessel vasculitis. The factor(s) that trigger the d evelopment of these autoantibodies and their role in the pathogenesis of vasculitis is still unclear. We describe four patients who presente d to us since June 1990. All patients had positive ANCA serology and h ad clinical evidence of vasculitis. In all patients soon after the est ablishment of ANCA positivity, a carcinoma of either the respiratory o r urinary tracts was diagnosed. We suggest that in some cases of ANCA- associated vasculitis, malignant disease may be a trigger for either t he generation of these autoantibodies, or the development of vasculiti s.