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Testing with Antineutrophil Cytoplasmic Antibody To Diagnose Wegener Granulomatosis
- Stephen D.H. Malnick, MA, MSc, MBBS;
- Ella Evron, MD; and
- Zev M. Sthoeger, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
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TO THE EDITOR:
The recent paper by Rao and colleagues [1] was most interesting. We wish to explain the low positive predictive value of 63% for a positive c-ANCA test that the authors noted.
Approximately 2% of the world's population is estimated to have chronic hepatitis C virus (HCV) infection [2]. It is now apparent that several extrahepatic manifestations are linked to chronic HCV disease [3]. These include vasculitis and cryoglobulinemia, which may cause symptoms similar to those of Wegener granulomatosis. We recently found a high (43.8%) incidence of c-ANCA in a cohort of patients with chronic HCV disease [4] who were referred consecutively to the liver clinic at our hospital. If our findings are applicable to the world population of patients with HCV infection, more than 100 million persons may have c-ANCA antibodies in association with chronic HCV infection. Thus, one may encounter patients with a suspicious clinical picture and c-ANCA antibodies possibly linked to HCV rather than to Wegener granulomatosis.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
