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Q J Med 1995; 88: 775-783
© 1995 Association of Physicians

Antigen specificity in hydralazine associated ANCA positive systemic vasculitis

A.K. SHORT and C.M. LOCKWOOD

Department of Medicine, School of Clinical Medicine, University of Cambridge Cambridge, UK

Received 8 December 1994 Accepted for publication 29 June 1995.


  Abstract

The anti-hypertensive agent hydralazine can cause a lupus-like syndrome characterized by serosal inflammation, arthralgias and rashes. The kidneys however are usually spared. The condition is characterized by circulating immune complexes and antinuclear antibodies, whilst antibodies against doublestranded DNA are rare. Hydralazine can also cause a systemic vasculitis with a pauci-immune rapidly progressive glomerulonephritis, which is associated with autoantibodies directed against components of the neutrophil cytoplasm. In this study, ten patients with hydralazine-induced vasculitis had antibodies with specificities for both myeloperoxidase and lactoferrin. We suggest that this particular pattern of autoantibodies, together with antibodies with reactivity against nuclear components including double-stranded DNA, are characteristic findings in hydralazine-induced vasculitis. In addition, renal involvement appears to be more common in this group of patients with vasculitis than in those with the lupus-like syndrome.


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