THE PRESENCE OF CYTOPLASMIC ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES (C-ANCA) IN THE COURSE OF SUBACUTE BACTERIAL-ENDOCARDITIS WITH GLOMERULARINVOLVEMENT, COINCIDENCE OR ASSOCIATION

Antineutrophil cytoplasmic antibodies positivity with cytoplasmic patt ern (C-ANCA) and proteinase-3 (PR-3) specificity was found in two pati ents with both subacute bacterial endocarditis (SEE) and glomerular in volvement. Renal biopsy showed membranoproliferative glomerulonephriti s in one case and focal segmental glomerulonephritis in the second cas e. Immunofluorescence study showed granular immune deposits in both ca ses evocating immune complex glomerulonephritis. Renal and biological manifestations disappeared with clinical improvement secondary to anti biotherapy. Physicians have to consider the possible occurrence of suc h C-PR-3 ANCA, claimed to be specific markers for Wegener's granulomat osis, in infectious diseases such as SEE. Hence we focus on the necess ity of performing a renal biopsy with light microscopy and immunofluor escence studies in all patients with ANCA associated glomerular diseas e.