Occurrence of Autoqntibodies Directed Against Myeloperoxidase and Elastase in Patients Treated with Hydralazine and Presenting with Glomerulonephritis

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<jats:p> We have undertaken an investigation retrospectively of 21 patients with positive antinuclear antibodies, who had been on hydralazine treatment and developed a glomerulonephritis. Four patients had circulating antimyeloperoxidase (MPO) and two of them were concluded to have a hydralazine-induced glomerulonephritis, corresponding to a frequency of 10%. These two patients had antibodies of IgG and IgM class directed against myeloperoxidase (MPO), and also antibodies against elastase. These two patients had also a biopsy proven extracapillary glomerulonephritis with focal segmental necrosis. </jats:p><jats:p> Antibodies against elastase were furthermore seen in three patients with proliferative glomerulonephritis and in one patient with membranoproliferative glomerulonephritis. </jats:p><jats:p> This study confirms an association between circulating anti-MPO and a histopathological picture compatible with extracapillary proliferation and focal segmental necrosis. From a clinical, histopathological and serological point of view it can be concluded that in two patients the glomerulonephritis was associated with antibody evidence of an autoimmune side effect. </jats:p>

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