Among the pathogens known to mediate ANCA production, Streptococcus and Staphylococcus are dominant,[3,4,7,8] but others include Tuberculosis bacilli, Legionella, and other invasive aspergillosis, hepatitis C virus, parvovirus B19, and Bartonella, which can cause PR3/MPO-ANCA positivity.[10,20] Therefore, timely microbial culture or pathogen-specific antibody detection is important, especially in patients with heart disease. This evidence concerns the gene MPO and heart disorder.