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Anti-neutrophil cytoplasmic antibodies in patients with chromomycosis.

OBJECTIVE: Antineutrophil cytoplasmic antibodies (ANCA) are a family of antibodies that react to proteins within neutrophil granules and monocyte lysosomes, and occur prominently in sera from patients with systemic necrotizing vasculitis. The cytoplasmic staining pattern (c-ANCA) is very sensitive and specific for Wegener's granulomatosis (WG), and most commonly results from reactivity with proteinase 3 (PR3). The features of tissue damage in the fungal infection chromomycosis, in particular polymorphonuclear neutrophil (PMN) infiltration and granuloma formation, bear a resemblance to that seen in WG. METHODS: We tested sera from 25 patients with clinical and histologic diagnosis of chromomycosis for the presence of ANCA by indirect immunofluorescence. These same sera were analyzed for reactivity to neutrophil primary granule extracts and PR3 by ELISA. RESULTS: Five of the 25 patients (20%) had detectable c-ANCA, without central accentuation, at serum dilutions of at least 1:40. Three of these 5 ANCA-positive patients reacted with neutrophil primary granule extracts by ELISA; however, none of them reacted with PR3. CONCLUSIONS: These results demonstrate that fungal infection should be included among the conditions, unrelated to necrotizing vasculitis, that can trigger autoreactivity against myeloid lysosomal antigens.

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PubMed1976

[Chromomycosis in Iberia].

A 66 year old, Spaniard, born at Sueca (Valencia Province), was found infected with "Fonsecaea pedrosoi". His lesion, located in the inner aspect of the right arm, appeared when he was 7-8 years old, and progressed very slowly until he migrated to Venezuela, at 42. Thereafter it progressed more rapidly and started to hurt. Treatment included administration of 5-flucytosine at the daily dose of 150 mg./kg. during 4 and a half months and thermotherapy by means of a permanent adhesive tape on the lesion during 6 months. Eleven months after completion of the treatment, the patient is asymptomatic. This is the second case of chromomycosis originating in the Iberian peninsula. The importance of climate, clothing and age is discussed with reference to epidemiology of chromomycosis. The isolated strain of "F. pedrosoi" is the first one from the same region: its cultural characteristics and virulence among mice are studied and reported with some details. We think that in Europe, and especially in the Mediterranean countries, cases of chromomycosis did possibly occur, which were labelled as tuberculosis verrugosa or vegetans pyoderma owing to their histological picture.

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