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Aktuelle Rheumatologie 2017; 42(06): 538-543
DOI: 10.1055/s-0042-124358
Übersichtsarbeit
Georg Thieme Verlag KG Stuttgart · New York

Ein positiver ANA/ANCA-Befund – es muss nicht immer eine Kollagenose sein

Positive ANA/ANCA Detection – not Always Collagenosis
Werner-Johannes Mayet
1   Zentrum für Innere Medizin, Nordwest-Krankenhaus Sanderbusch gGmbH, Sande
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Publication History

Publication Date:
18 May 2017 (online)

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Zusammenfassung

Der Nachweis von Autoantikörpern ist mittlerweile essentieller Bestandteil der rheumatologischen Routinediagnostik von Kollagenosen bzw. Vaskulitiden. Dies gilt besonders für antinukleäre Antikörper (ANA) und anti-neutrophile zytoplasmatische Antikörper (ANCA). Da diese Antikörperspezifitäten jedoch auch bei gastroenterologischen Erkrankungen gefunden werden, sind durchaus Fehlinterpretationen möglich. So kann bspw. eine falsche Zuordnung eines Antikörperbefundes im Rahmen einer Virushepatitis zu einem für die gastroenterologische Grunderkrankung ungünstigen Einsatz von Immunsuppressiva führen. Um auf der sicheren Seite zu sein, ist also eine genaue Kenntnis der differenzialdiagnostischen Abgrenzung von ANA und ANCA Befunden in der Rheumatologie und Gastroenterologie notwendig.

Abstract

The detection of autoantibodies has become an essential part of the rheumatological routine diagnostic evaluation of collagenosis and vasculitis. This is especially true for antinuclear antibodies (ANA) and anti-neutrophil cytoplasmic antibodies (ANCA). However, as these antibody specificities are also found in gastroenterological diseases, misinterpretations are entirely possible. For example, if antibody findings are incorrectly attributed to a rheumatological disease in the context of viral hepatitis, this may lead to administration of immunosuppressants with unfavourable effects regarding the underlying gastroenterological disease. Avoiding such risks requires precise knowledge of the differential diagnostic evaluation of ANA and ANCA findings in rheumatology and gastroenterology.

Schlüsselwörter

Autoantikörper - ANA - ANCA - Kollagenosen - Gastroenterologie

Key words

ANA - ANCA - collagenosis - gastroenterology - autoantibodies
 

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