ANTIGEN-SPECIFICITY IN HYDRALAZINE ASSOCIATED ANCA POSITIVE SYSTEMIC VASCULITIS

The anti-hypertensive agent hydralazine can cause a lupus-like syndrom e characterized by serosal inflammation, arthralgias and rashes. The k idneys however are usually spared. The condition is characterized by c irculating immune complexes and anti-nuclear antibodies, whilst antibo dies against double-stranded DNA are rare. Hydralazine can also cause a systemic vasculitis with a pauci-immune rapidly progressive glomerul onephritis, which is associated. with autoantibodies directed against components of the neutrophil cytoplasm. In this study, ten patients wi th hydralazine-induced vasculitis had antibodies with specificities fo r both myeloperoxidase and lactoferrin. We suggest that this particula r pattern of autoantibodies, together with antibodies with reactivity against nuclear components including double-stranded DNA, are characte ristic findings in hydralazine-induced vasculitis. In addition, renal involvement appears to be more common in this group of patients with v asculitis than in those with the lupus-like syndrome.