correct!
Answer: D. Atypical p-ANCA antibody.
Perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) are found in up to 80% of PSC patients - they are atypical, according to Robbins, because they are directed against a nuclear envelope protein insted of myeloperoxidase; however, the histologic appearance is the same as other p-ANCAs.
Answer: D. Atypical p-ANCA antibody.
Perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) are found in up to 80% of PSC patients - they are atypical, according to Robbins, because they are directed against a nuclear envelope protein insted of myeloperoxidase; however, the histologic appearance is the same as other p-ANCAs.
- p-ANCAs are also found in patients with Churg-Strauss syndrome (50%), microscopic polyangiitis (60%; rarely positive in polyarteritis nodosa now that PAN and MPA are classified as different diseases, but might still be associated on the boards), Kawasaki disease, glomerular basement membrane disease, rheumatoid arthritis (especially JRA), IBD (Crohn's and ulcerative colitis), and drug-induced vasculitis.
- 75-90% of PSC patients have IBD
- 87% of these ulcerative colitis
- 13% with Crohn colitis
- 75-90% of PSC patients have IBD
- c-ANCA is associated with Wegener's granulomatosis
- anti-HepBc IgG (A) are indicative of past Hepatitis B infection
- anti-glycoprotein 210 (B) is found in primary biliary cirrhosis
- anti-topoisomerase (C) is found in systemic scleroderma
- Von Meyenburg complexes (E) are not immune complexes; rather, they are clinically non-significant fibrous clusters that can look like like liver metastases.
