Vai ai contenuti. | Spostati sulla navigazione | Spostati sulla ricerca | Vai al menu | Contatti | Accessibilità

| Crea un account

De Pellegrin, Annamaria (2008) Role of ANCA in necrotizing vasculitis and in chronic inflammatory
intestinal disease.
[Tesi di dottorato]

Full text disponibile come:

[img]
Anteprima
Documento PDF
207Kb
[img]
Anteprima
Documento PDF
34Kb
[img]
Anteprima
Documento PDF
35Kb
[img]
Anteprima
Documento PDF
36Kb
[img]
Anteprima
Documento PDF
24Kb
[img]
Anteprima
Documento PDF
29Kb

Abstract (inglese)

Background: Wegener's granulomatosis (WG), Microscopic Poliangitis and Churg-Strauss Syndrome, the necrotizing vasculitis, are a group of inflammatory diseases of the
wall small-medium calibre blood vessels. This group of diseases are hystologically characterized by the presence of necrotic tissue with a consequent inflammatory infiltration and the formation of granulomas. GW is a disease which has periods of
remission and recurrence treated by therapeutic cycles associated with several side-effects. It is caracterized by the presence in serum of anti-neutrophil cytoplasm antibodies (ANCA). ANCA are auto-antibodies against enzymatic antigens
found in primary granules of neutrophyls and in peroxydase-positive lysosomes of monocytes.The two main antigens are serin proteinase-3 (PR3), a cytoplasmatic
protein and leucocyte myeloperoxydase (MPO). Indirect immunofluorescence permits to differentiate two distinct patterns, cytoplasmic (c-ANCA) and perinuclear (p-ANCA),
according to the involved antigen, accordingly PR3 and MPO.
Both patterns of ANCA presentation, mainly p-ANCA, are found in chronic inflammatory intestinal disease (IBD), noticeably Crohn's disease (CD) and ulcerative colitis (UC).
Study goal: To evaluate the prevalence of ANCA in a population of patients with WG and one with CIID. In these two groups we studied: presentation pattern, correlation among antibody titer, clinical phase and disease localization; the role of infective
agents as factors initiating ANCA production. Finally we correlated ANCA titers with response to treatment and disease complications. Patients and methods: we studied 13 patients with WG, some of which we had treated for over 7 years. In all patients ANCA levels were titred at the moment of diagnosis
and during recurrences. Cultures were performed during episdoes of infectious disease. 37 patients with IBD admitted to a general surgical department for colic resection or for treatment of anal abscesses or fistulas were also studied, of these 12 had UC and 15 CD. Patients were studied in 2 different stages: preoperatively and 3 months after surgery. We evalutated:ANCA dosage, erythrocyte sedimentation rate, CRP, fibrinogen levels, direct or anamnestic determination of infectious episodes. Serum ANCA levels were dosed according to indirect immunofluorescence and, if positive, their presence was confirmed by ELISA.
Results: ANCA were useful, if not decisive, in 85% of patients with WG, with titers ranging from 1:160 to 1:280. c-ANCA were 100% specific in patients with WG. ANCAs reappeared during follow-up in only 3 patients . Infectious episodes seemed to have been the factor causing recurrence. The presence of Staphylococcus aureus seems to favor the reappearance of ANCA in patients with WG while bactertial and/or viral infections may be responsible for ANCA-negative. p-ANCA were detected in 83% of patients with CU and in only 20% of patients with MC before surgery. After surgical treatment, ANCA were detected in 75% of patients with CU, while remain 20% in MC patients, but with lower titer.
Conclusions: also our study demonstrates to the usefulness of the search and dosage of the ANCA in the diagnosis and follow-up of the GW. P-ANCA had a clean prevalence
in the UC but they aren't useful in other chronic diseases. Also not playing a determining role in the diagnosis and not predicting in the prognosis of the IBD, ANCA turns out from our study a useful additional test in the diagnostic one
differentiates them between UC and MC.


Statistiche Download - Aggiungi a RefWorks
Tipo di EPrint:Tesi di dottorato
Relatore:Ossi, Elena
Dottorato (corsi e scuole):Ciclo 20 > Scuole per il 20simo ciclo > SCIENZE MEDICHE, CLINICHE E SPERIMENTALI > FISIOPATOLOGIA CLINICA
Data di deposito della tesi:31 Gennaio 2008
Anno di Pubblicazione:31 Gennaio 2008
Parole chiave (italiano / inglese):ANCA, necrotizing vasculitis, chronic inflammatory intestinal disease
Settori scientifico-disciplinari MIUR:Area 06 - Scienze mediche > MED/09 Medicina interna
Struttura di riferimento:Dipartimenti > Dipartimento di Specialità Medico-Chirurgiche
Codice ID:860
Depositato il:08 Ott 2008
Simple Metadata
Full Metadata
EndNote Format

Bibliografia

I riferimenti della bibliografia possono essere cercati con Cerca la citazione di AIRE, copiando il titolo dell'articolo (o del libro) e la rivista (se presente) nei campi appositi di "Cerca la Citazione di AIRE".
Le url contenute in alcuni riferimenti sono raggiungibili cliccando sul link alla fine della citazione (Vai!) e tramite Google (Ricerca con Google). Il risultato dipende dalla formattazione della citazione.

1. Davies D.J., Moran J.E., Niall J.F., Ryann G.B.: Segmental necrotizing glomerulonephritis with antineutrophil antibody: possible arbovirus aetiology? BMJ 285: 606 (1982). Cerca con Google

2. Hall J.B., Wadham B.M., Wood C.J., Ashron V., Adam W.R.: Vasculitis and glomerulonephritis: a subgroup with an antineutrophil cytoplasmic antibody. Aust N Z J Med 14: 277-78 (1984). Cerca con Google

3. Calabresi P., Edwards E.A., Shilling R.F.: Fluorescent antiglobulin studies in leukopenic and related disorders. Blood 13: 2091-100 (1959). Cerca con Google

4. Van der Woude F.J., Rasmussen N., Lobarro S.: Autoantibodies against neutrophil and monocytes: rool for diagnosis and marker of disease activity in Wegener’s Granulomatosis. Lancet 1: 425-29 (1985). Cerca con Google

5. Gross W.L., Schmitt W.H.: ANCA and associated disease: immunodiagnostic and pathogenetic aspects. Clin Exp Immunol 91: 1-12 (1993). Cerca con Google

6. Kallenberg C.G.M., Brawer E., Weening J.J., Cohen Tervaert J.W.: Antineutrophil cytoplasmic antibodies: current diagnostic and pathophisiological potential. Kidney Int 46: 1-15 (1994). Cerca con Google

7. Jennette J.C., Falk R.J., Andrassy K., Bacon P.A., Churg J., Gross W.L., Hogan E.C., Hoffman G.S., Hunder G.G., Kallenberg C.G.M., Mc Kluskey R.T., Sinico R.A., Rees A.J., van Es L.A., Waldherr R., Wiik A.: Nomenclature of systemic vasculitidies: the proposal of an international consensus conference. Arthritis Rheum 37: 187-92 (1994). Cerca con Google

8. Jennette J.C., Falk R.J: Antineutrophil cytoplasmic autoantibodies: discovery specificity, disease associations and pathogenetic potential. Adv Pathol Lab Med 8: 363-78 (1995). Cerca con Google

9. Hoffman G.S., Specks U.: Antineutrophil cytoplasmic antibodies. Arthritis Rheum 41: 1521-37 (1998). Cerca con Google

10. Wiik A.: Delineation of a standard procedure for indirect immunofluorescence detection of ANCA. APMIS 97 (suppl. 6): 12 (1989). Cerca con Google

11. Glodshmeding R., Van der Schoor C.E., Bokkel D.: Wegener’s granulomatosis autoantibodies identify a novel diisopropylfluorophosphate binding-protein in the lyososmes of normal human neutrophils. J Clin Invest 84: 1577-87 (1989). Cerca con Google

12. Niles J.L., Mc Kluskey R.T., Ahmad M.F., Amaour M.A.: Wegener’s Granulomatosis autoantigens in a novel neutrophil serin-proteinase. Blood 74: 1888-93 (1989). Cerca con Google

13. Ludemann L., Utecht B., Gross W.L.: Anti-neutrophil cytoplasmic antibodies in Wegener’s Granulomatosis recognise an elastinolitic enzyme. J Exp Med 171: 357-62 (1990). Cerca con Google

14. Jennette J.C., Hojdal J.R., Falk R.J.: Specificity of anti-neutrophil cytoplasmic autoantibodies for proteinase3. Blood 75: 2263-4 (1990). Cerca con Google

15. Falk R.J., Jennette J.C.: Anti-neutrophil cytoplasmic autoantibodies with specificity for mieloperoxidase in patient with systemic vasculitis and idiopathic necrotizing and crescentic glomerulonephritis. NEJM 318: 1651-7 (1988). Cerca con Google

16. Peen E., Almer S., Bodemar G., Ryder B.O., Sjolin C., Tejle K., Skogh T.: Antilactoferrin antibodies and other types of ANCA in ulcerative colitis, primary sclerosis cholangitis and Crohn’s disease. Gut 34: 56-62 (1993). Cerca con Google

17. Lee S.S., Lawton L.W.M., Chan C. E.: Antilactoferrin antibody in systemic lupus erythematosus. Br J Rheumatol 31: 669-73 (1992). Cerca con Google

18. Cohen Tervaert J.W., Mulder A.H.L., Stegeman C.A., Elema J.D., Huitema M.G., The T.H., Granulomatosis and other inflammatory disease. An Rheum Dis 52: 115-20 (1993). Cerca con Google

19. Halbwachs-Mecarelli L.H., Nusbaum L.H., Noel L.H., Reumaux D., Erlinger S., Grunfeld J.P., Lasavre P.: ANCA direct against cathepsin G in ulcerative colitis, Crohn’s disease and primary sclerosis cholangitis. Clin Exp Immunol 90: 79-80 (1992). Cerca con Google

20. Zhao M.H., Jones S.J., Lockwood C.M.: Bactericidal permeability incrising protein (BPI) is an important antigen for anti-neutrophil cytoplasmic autoantibodies (ANCA) in vasculitis. Clin Exp Immunol 99: 49-56 (1995). Cerca con Google

21. Lasavre P: Antineutrophil cytoplasmic autoantibodies antigen specificity. Am J Kidney Dis 18: 159-63 (1991). Cerca con Google

22. Mulder A.H.L., Breakraelofs J., Horst G., Limberg P.C., Nelis G.F., Kallenberg C.G.M.: ANCA in inflammatory bowel disease: characterization and clinical correlates. Clin Exp Immunol 95: 490-7 (1994). Cerca con Google

23. Mulder A.H.L., Horst G., van Leeuwen M.A., Limburg P.C., Kallenberg C.G.M.: Antineutrophil cytoplasmic autoantibodies in rheumatoid arthritis: characterization and clinical correlation. Arthritis Rheum 36: 1554-60 (1993). Cerca con Google

24. Aitola P., Miettinen A., Mattile A.: Effect of proctocolectomy on serum antineutrophil cytoplasmic antibodies in patients with chronic ulcerative cholitis. J Clin Pathol 48: 645-7 (1995). Cerca con Google

25. Peter H.H., Metzger D., Rump A., Roter E.: ANCA in disease other than systemic vasculitis. Clin Exp Immunol 91 (suppl. 1): S12-14 (1993). Cerca con Google

26. Reumaux D., Duthilleu P., Roos D.: Pathogenesis of disease associated with antineutrophil cytoplasm autoantibodies. Human Immunol 65: 1-12 (2004). Cerca con Google

27. Egner W., Chapel H.M.: Titolation of antibody against neutrophil cytoplasmic antigen is useful in monitoring disease activity in systemic vasculitis. Clin Exp Immunol 82: 244-9 (1990). Cerca con Google

28. Cohen Tervaert J.W., Huitema M.G., Henè R.J., The T.H., Van der Hem G.K., Kallenberg C.G.M.: Prevention of relapses in Wegener’s Granulomatosis by treatment based on ANCA titer. Lancet 336: 709-11 (1990). Cerca con Google

29. Kerr G.R., Fleisher T.H.A., Hallahan C.W., Leavitt R.Y., Fauci A.S., Hoffman G.S.: Limited prognostic value of changes in ANCA titer in patients with Wegener’s Granulomatosis. Arthitis Rheum 36: 365-71 (1993). Cerca con Google

30. Gasking G., Savage C.O.S., Ryan J.J., Jones S., Lockwood C.M., Rees A.J., Pusey C.D.: Anti-neutrophil cytoplasmic antibody and disease activity during long term follow-up of 70 patients with systemic vasculitis. Nephrol Dial Transplant 6: 689-94 (1991). Cerca con Google

31. Dolman K.M., Gaus R.O.B., Vervaat T.J., Zevembergen G., Maingay D., Nikkels R.S., Donker A.J.M., Van dem Borne A.E.G.K., Goldschmhuman Eding R.: Vasculitis and antineutrophil cytoplasmic antibody associated with propylthiuracil therapy. Lancet 342: 651-2 (1993). Cerca con Google

32. Vogt B.A., Kim Y., Jennette J.C., Falk R.J., Burke B.A., Sinaiko A.: Antineutrophil cytoplasmic autoantibody-positive crescentic glomerulonephritis as a complication of treatment with propylthiouracil in children. J Pediatr 124: 986-8 (1994). Cerca con Google

33. D’Cruz D., Chesser A.M., Lightowler C., Comer M., Hurst M.J., Baker L.R., Raine A.E.: Antineutrophil cytoplasmic autoantibody-positive crescentic glomerulonephritis associated with anti-thiroid drug treatment. Br J Rheumatol 34: 1090-1 (1995). Cerca con Google

34. Charles L.A., Caldas M.L.R., Falk R.J., Terrel R.S., Jennette J.C.: Antibodies against granule proteins activate neutrophils in vitro. J Leuk Biol 50: 539-46 (1991). Cerca con Google

35. Falk R.J., Terrel R.S., Charles L.A., Jennette J.C.: Antineutrophil cytoplasmic autoantibody induce neutrophils to degranulate and produce oxygen radicals. Proc Natt Acad Sci USA 87: 4115-9 (1990). Cerca con Google

36. Ewert B.H., Jennette J.C., Falk R.J.: Anti-myeloperoxidase antibody stimulate neutrophils to damage endothelial cells. Kidney Int 41: 375-83 (1992). Cerca con Google

37. Savage C.D., Pottinger B.E., Gaskin G., Pusey C.: Autoantibiodies developing to myeloperoxidase and proteinase in systemic vasculitis stimulate neutrophil cytotoxicity toward cultured endothelial cells. Am J Pathol 141: 335-42 (1992). Cerca con Google

38. Vargunam M., Adu D., Taylor C.M., Michael J., Richards N., Neuberger J., Thompson R.A.: Endothelium myeloperoxidase-antimyeloperoxidase interaction in vasculitis. Nephrol Dial Transpl 1: 1077-81 (1992). Cerca con Google

39. Mayet W.J., Csernok E., Szymkowiak C., Gross W.L., zum Buschenfelden M.: Human endothelial cells express proteinase3, the target antigen of anticytoplasmic antibodies in Wegener’s Granulomatosis. Blood 82: 1221-9 (1993). Cerca con Google

40. Brockmann H., Schwarting A., Kriegsmann J., Gaumann G.G., Muller K.M., Galle P.R.: Proteinase 3 as the major autoantigen of c-ANCA is sovraexpressed in lung tissue of patients with Wegener’s Granulomatosis. Arthritis Res 4: 220-5 (2002). Cerca con Google

41. Jenette J.C., Falk R.J.: Pathogenesis of vascular and glomerular damage in ANCA-positive vasculitis. Nephrol Dial Transplant 13 (suppl.1): 16-20 (1998). Cerca con Google

42. Hoffmann G.S.: Classification of the systemic vasculitides: antineutrophil cytoplasmic antibodies, consensus and controversy. Clin Exp Rheumatol 16: 111- 5 (1998). Cerca con Google

43. Jennette J.C.: Antineutrophil cytoplasmic autoantibody-associated disease: a pathologist’s perspective. Am J Kidney Dis 18: 164-70 (1991). Cerca con Google

44. Hellmich B., Csernok E., Gross W.L.: 20 years with ANCA: from seromarker to a major pathogenic palyer in vasculitis. J Leuk Biol 74: 1-2 (2003). Cerca con Google

45. Fauci A.S., Haynes B.F., Katz P., Wolff S.M.: Wegener’s Granuolmatosis: perspective clinical and therapeutic experience with 85 patients for 21 years. Ann Intern Med 98: 76-85 (1983). Cerca con Google

46. Leavitt R.Y., Fauci A.S., Bloch D.A.: The American College of Rheumatology 1990 criteria for the classification of Wegener’s Granulomatosis. Arthitis Rheum 33: 1101-7 (1990). Cerca con Google

47. Duna G.F., Galperin C., Hoffman G.S.: Wegener’s Granulomatosis. Rheum Dic Clin North Am 21: 949-86 (1995). Cerca con Google

48. Van der Geld Y.M., Tool A.T., Videler J., De Haas M., Tervaert J.W., Stegeman C.A., Limburg P.C., Kallenberg C.G., Roos D.: Interference of PR3-ANCA with the enzymatic activity of PR3: difference in patients during active disease or remission of Wegener’s Granulomatosis. Clin Exp Immunol 129: 562-70 (2002). Cerca con Google

49. Schultz H., Heintz H., Van Zandbergen G., Ullrich S., Reinhold-Keller E., Gross W.L.: ANCA against the bactericidal/permeability incrising protein (PBI-ANCA) compromise the antibiotic function of BPI in a Wegener’s granulomatosis. Clin Exp Rheumatol 21: 763-6 (2003). Cerca con Google

50. Stegeman C.A., Cohen Tervaert J.W., Sluiter W.J., Manson W., Jong P.E., Kallenberg C.G.M.: Association of chronic nasal carriage of Staphylococcus aureus and higher relapse rate in Wegener’s Granulomatosis. Ann Intern Med 113: 12-7 (1994). Cerca con Google

51. Popa E.R., Stegeman C.A., Kallenberg C.G.M., Cohen Tervaert J.W.: Staphylococcus aureus and Wegener’s granulomatosis. Arthritis Res 4: 77-9 (2002). Cerca con Google

52. Voswinkel J., Kramer J., Muller A.: B-lymphocyte infiltrating Wegenr’s granuloma: the immunoglobulin VH gene repertoire from granulomatous tissues displays an antigen-driven maturations and suggest a microbial trigger. Arthritis Res 6: 24 (2004). Cerca con Google

53. Specks U., Whestley C.L., Mc Donald T.J.: Anticytoplasmic autoantibody in the diagnosis and follow-up of Wegener’s Granulomatosis. Mayo Clin Proc 64: 28- 36 (1989). Cerca con Google

54. Weidebach W., Viana V.S.T., Leon E.P., Bueno C., Leme A.S., Arantes-Costa F.M., Martins M.A., Saldiva P.H.N., Bonfa E.: c-ANCA-positive fraction from patients with Wegener’s Granulomatosis induces lung vasculitis in rats. Clin Exp Immunol 129: 54-60 (2002). Cerca con Google

55. Rao J.K., Weinberger M., Oddone E.Z., Allen N.B., Landsman P., Freussner J.R.: The role of anti-neutrophil cytoplasmic antibody (c-ANCA) testing in the diagnosis of Wegener’s Granulomatosis. Ann Intern Med 123: 925-32 (1996). Cerca con Google

56. Nolle B., Specks U., Ludemann J., Korhbach M.S., De Remee R.A., Gross W.L.: Anticytoplasmic autoantibodies: their immunologic value in Wegener’s Granulomatosis. Ann Intern Med 111: 28-40 (1989). Cerca con Google

57. Walton E.W.: Giant cell granuloma of the respiratory tract (Wegener’s Granulomatosis). BMJ 2: 265-70 (1958). Cerca con Google

58. Carrington C.B., Liebow A.A.: Limited forms of angiitis and granulomatosis of Wegener’s type. Am J Med 41: 497-527 (1966). Cerca con Google

59. Savage C.O., Harper L., Holland M.: New findings in pathogenesis of antineutrophil cytoplasm antibody-associated vasculitis. Curr Opin Rheumatol 14;15-22 (2002). Cerca con Google

60. Yamashita K., Kobayashi K., Kondo M., Ishikura H., Shibuya Y., Hayasaka S.: Elevated anti-neutrophil cytoplasmic antibody titer in a patient with atypical orbital pseudotumor. Ophtalmologica 209: 172-5 (1995). Cerca con Google

61. Thajeb P., Tsai J.J.: Cerebral and oculorhinal manifestatios of a limited form of Wegener’s Granulomatosis with c-ANCA-associated vasculitis. J Neuroimaging 11: 59-62 (2001). Cerca con Google

62. Gross W.L.: Immunopathogenesis of vasculitis. Rheumatology 2: 1601-9 (2003). Cerca con Google

63. Santana AN, Antunes T, Barbas CS. Treatment of ANCA-associated vasculitis JAMA. 2007 Dec 19;298(23):2739.. Cerca con Google

64. Yazici Y. Vasculitis update, 2007. Bull NYU Hosp Jt Dis. 2007;65(3):212-4. Review. Cerca con Google

65. Rarok A.A., Stegeman C.A., Limburg P.C., Kallember C.G.M.: Neutrophil membrane expression of proteinase 3 (PR3) is related to relapse in PR3-ANCAassociated vasculitis. J Am Soc Nephrol 13 : 2232-8 (2002). Cerca con Google

66. Van Rossum A.P., Rarok A.A., Huitema M.G., Limburg P.C., Kallenberg C.G.M.: Costitutive membrane expression of proteinase 3 and neutrophil activation by anti-PR3 antibodies. Kidney Blood Press Res 26: 265 (2003). Cerca con Google

67. Slot M.C., Cohen Tervaert J.W., Boomsma M.M., Stegeman C.A.: Positive c- ANCA titer at switch to azatyoprine therapy is associated with relapse in proteinase 3-related vasculitis. Arthritis Rheum 51: 269-73 (2004). Cerca con Google

68. Boomsma M.M., Stegeman C.A., Van der Leij M.J., Oost W., Herman J., Kallenberg., Limburg P.C., Cohen Tervaert J.W.: Prediction of relapses in Wegener’s Granulomatosis by measurement of anti neutrophil cytoplasmic antibody levels; a prospective study. Arthritis Rheum 43: 2025-33 (2000). Cerca con Google

69. Mc Kay D.M.: Bacterial superantigens: provocateurs of gut dysfunction and inflammation? Trends Immunol 22: 497-501 (2001). Cerca con Google

70. Fiocchi C.: Inflammatory bowel disease: etiology angd pathogenesis. Gastroenterology 115: 182-205 (1198). Cerca con Google

71. Mayers A.L., Colombo J., Jackson M.A., Harrison C.J., Robrts C.R. : Tuberculous colitis mimicking Crohn Disease. J Pediatr Gastroenterol Nutr: 45 (5) : 607-10 (2007). Cerca con Google

72. Podolsky D.K.: Inflammatory bowel disease. NEJM 347: 417-28 (2002). Cerca con Google

73. Kappelman M.D., Rifas-Shiman S.L., Kleinmann K., Ollendorf D., Bousvaros A., Grand R.J., Finkelstein J.A.: The prevalence and geographic distribution of Crohn’s desease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol: 5 (12): 1424-9 (2007). Cerca con Google

74. Carter M.J., Jones S., Mansfield J.C., et al: Further evidence of an association between the allele 2 of the interleukin 1 receptor antagonist (IL-1ra) gene (IL- 1RM) polymorphism and ulcerative colitis. Gastroenterology: 114 A 948 (1998). Cerca con Google

75. Papo M., Quer J.C., Gutierrez C. et al. and Richart C.: Genetic heterogeneity within ulcerative colitis determined by interleukin-1 receptor antagonist gene polymorphism and antineutrophil cytoplasmic antibodies. Eur J Gastroenterol Hepatol 11: 413-420 (1999). Cerca con Google

76. Gross W.L., Schmitt W.H., Csernoki E. ; ANCA and associated diseases; immunodiagnostic and pathogenetic aspects. Clin Exp Immunol 91: 1-12 (1993). Cerca con Google

77. Roozendaal C., Van Milligen de Wit M. et al. : Antineutrophil Cytoplasmatic Antibodies in primary sclerosing Cholangitis: Defined specificities may be associated with distinct clinical features. Am J Med. 105: 393-399 (1998). Cerca con Google

78. Quinton J.F., Sendid B., Reumax D., Duthilleul P., Grandbastien B., Charrier G., Targan S.R., Poulain D. : Anti Saccharomyces cerevisiae mannan antibodies combined with antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease:prevalence and diagnostic role. Gut 42:788-791 (1998). Cerca con Google

79. Vecchi M., Sinico A., Bianchi M.B., Radice A., Giochetti P., Campieri M. & De Franchis R. : Recognition of bacterici-dal/permeability-increasing protein by perinuclear Anti Neutrophil Cytoplasmic Antibody-positive sera from ulcerative colitis patients:prevalence and clinical significance. Scand J Gastroenterol 33, 1284-1288 (1998). Cerca con Google

80. Langan r.C., Gotsh P. B., Krafczyk M.A.,Skillinge D.D.: Ulcerative colitis: Diagnosis and treatment. Am Fam Physician 1; 76 (9): 1323-30 (2007). Cerca con Google

81. Baert F., Caprilli R. Angelucci E.: Medical Therapy for Crohn’s disease: topdown or step-up? Dig Dis 25 (3) 260-6 (2007). Cerca con Google

82. Dawwas M.F.: Colectomy and IBD. Does surgery improve survival? BMJ 1; 335 (7630): 1109-10 (2007). Cerca con Google

83. Roozendaal C. and Kallenberg C.G.M. : Are anti-neutrophil cytoplasmic antibodies (ANCA) clinically useful in inflammatory bowel diseases (IBD)? Clin Axp Immunol 116: 206-213 (1999). Cerca con Google

84. Sandborn W.J: Serologic markers in inflammatory bowel disease: state of the art. Rev Gastroenterol Disord. 4 (4): 167-74 (2004). Cerca con Google

85. Abad E., Tural C., Mirapeix E. and Cuxart A.: Relationship between ANCA and Clinical activity in inflammatory Bowel Disease: Variation in prevalence of ANCA and Evidence of heterogeneity. Journal of Autoimmunity (1997) 10, 175- 180. Cerca con Google

86. Roozendaal C. , Pogany K., Horst G., et al. and Kallenberg C.G.M. : Does analysis of the antigenic specificities of Anti-neutrophil Cytoplasmic Antibodies contribute to their clinical significance in the inflammatory bowel diseases? Scand J Gastroenterol 34, 1123-1131 (1999). Cerca con Google

Download statistics

Solo per lo Staff dell Archivio: Modifica questo record