Anti-neutrophil cytoplasmic antibody-associated vasculitis with renal involvement: Analysis of 89 cases

Caravaca-Fontán, Fernando; Yerovi, Estefanía; Delgado-Yagüe, María; Galeano, Cristina; Pampa-Saico, Saúl; Tenorio, María; Liaño, Fernando

doi:10.1016/j.medcle.2017.01.009

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…Drooger et al . [21] and Caravaca et al [22]. Nonetheless, it is worth noting that not all long-term epidemiology studies of AAV have shown improved outcomes.…”

Section: Discussionmentioning

confidence: 99%

Comparing outcomes of biopsy-proven anti-neutrophil cytoplasmic autoantibody-associated glomerulonephritis patients treated with cyclophosphamide in the 20th and 21st centuries: a 23-year study

Whatmough

Fernandez

Sweeney

et al. 2018

Clinical Kidney Journal

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BackgroundAnti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) is a multisystem autoimmune disorder associated with significant morbidity and mortality. Approximately 80–90% of patients have circulating ANCAs. Long-term outcomes appear to be improving. This retrospective study analyses the incidence and patient outcomes over a period of 23 years at a single tertiary centre.MethodsOutcomes of patients diagnosed with AAV between 1 January 1988 and 31 December 2010 were collected retrospectively. Data including patient demographics, age of diagnosis, dates of starting renal replacement therapy, death and biochemistry results were collected. Patients were divided into two cohorts (1988–99 and 2000–10) and analysed using Stata software (StataCorp, College Station, TX, USA).ResultsA complete dataset was obtained for 273 patients. Of these patients, 101 were diagnosed between 1988 and 1999 while 172 were diagnosed between 2000 and 2010. The number of patients diagnosed with AAV increased from 2.2/million in 1988 to 10.3/million in 2010. A higher proportion of patients (56.4%) in the earlier cohort presented with creatinine >500 μmol/L compared with the later cohort (30.2%; P < 0.001). Overall patient survival improved significantly between the two cohorts. Cohort 1 had a median survival of 59 months compared with 125 months for Cohort 2 (P = 0.003).ConclusionsThis study shows that AAV is being diagnosed at an earlier stage, resulting in improved outcomes. This may be because of improvements in the management of AAV and chronic kidney disease.

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“…Drooger et al . [21] and Caravaca et al [22]. Nonetheless, it is worth noting that not all long-term epidemiology studies of AAV have shown improved outcomes.…”

Section: Discussionmentioning

confidence: 99%

Comparing outcomes of biopsy-proven anti-neutrophil cytoplasmic autoantibody-associated glomerulonephritis patients treated with cyclophosphamide in the 20th and 21st centuries: a 23-year study

Whatmough

Fernandez

Sweeney

et al. 2018

Clinical Kidney Journal

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show abstract

“…The contribution of both genetic factors and inhaled environmental exposures, including silica and asbestos, to the development of AAV has been previously reported . Although little is known about the association of cigarette smoking with the risk of AAV, several observational studies have suggested that smoking may influence AAV presentation . Smokers have been reported to have increased risk of AAV disease relapse and a lower prevalence of ear, nose, and throat damage compared with nonsmokers.…”

Section: Introductionmentioning

confidence: 99%

Association of Cigarette Smoking With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

McDermott

Stone

et al. 2020

JAMA Intern Med

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IMPORTANCE Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic small vessel vasculitis characterized by circulating ANCAs targeting proteinase 3 (PR3) or myeloperoxidase (MPO) and associated with excess morbidity and mortality. Myeloperoxidase-ANCA-positive AAV and PR3-ANCA-positive AAV are increasingly recognized to have differences in genetic risk, pathogenesis, and response to treatment. Risk factors for AAV, including cigarette smoking, are poorly understood.OBJECTIVE To examine the association between cigarette smoking and AAV. DESIGN, SETTING, AND PARTICIPANTSThis case-control study included a consecutive inception cohort of 484 patients with AAV diagnosed from 2002 to 2017 compared with a cohort of sex-, race-, and age-matched controls. Eleven cases were excluded owing to discordant smoking information in the electronic health record. Controls were randomly selected from participants recruited to the Partners HealthCare Biobank between its inception in 2010 and 2018 and who completed a smoking questionnaire and were not diagnosed with AAV (n = 30 536).EXPOSURES Smoking status (current, former, never) and pack-years of cigarette smoking were determined from review of the electronic medical record and smoking questionnaires. MAIN OUTCOMES AND MEASURESPatients with AAV were individually matched with 3 randomly-selected controls based on sex, race, and age (within 2 years difference). Conditional logistic regression was performed to examine the association between cigarette smoking and AAV using odds ratios (OR) and 95% confidence intervals (CIs). RESULTSOverall, 473 cases were matched with 1419 controls (mean [SD] age, 59 [16] years; 281 women [59%], 396 white [84%]). Patients with AAV were more likely to be former (OR, 1.6; 95% CI, 1.3-2.0) or current smokers (OR, 2.7; 95% CI, 1.8-4.1); there was a dose-response relationship according to pack-years of exposure (P < .001). These associations were especially strong among participants with MPO-ANCA-positive disease

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Analysis of Antineutrophil Cytoplasm Antibody from 118 730 Patients in Tertiary Hospitals in Jiangxi Province, China

et al. 2017

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BackgroundThe discovery of antineutrophil cytoplasm antibody (ANCA) makes the early diagnosis of primary vasculitis possible, and also has important guiding significance for the diagnosis and treatment of secondary vasculitis. This study aimed to investigate the clinical significance of ANCA.Material/MethodsANCA was detected by indirect immunofluorescence assay (IIF), and anti-myeloperoxidase (MPO) antibody, and anti-proteinase 3 (PR3) antibody were detected by ELISA. The results were analyzed retrospectively.ResultsAmong 118 730 patients, a total of 5853 (4.93%) were positive for ANCA. In the positive cases, 3.98% were male and 6.33% were female, with significant differences (χ2=123.38, P<0.01). For ANCA, the department with the highest positive rate (15.06%) was the Department of Rheumatology, followed by 7.78% in the Department of Dermatology, 6.79% in the Department of Nephrology, and 5.72% in the Department of Traditional Chinese Medicine (TCM). Anti-PR3 and cANCA were highly specific in primary vasculitis (P<0.01). Anti-MPO and pANCA had high specificity for other autoimmune diseases (P<0.01).ConclusionsANCA has important guiding significance for vasculitis-related diseases. Therefore, it is important in the diagnosis and treatment of this disease and has value in clinical practice.

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Anti-neutrophil cytoplasmic antibody-associated vasculitis with renal involvement: Analysis of 89 cases

Cited by 4 publications

References 25 publications

Comparing outcomes of biopsy-proven anti-neutrophil cytoplasmic autoantibody-associated glomerulonephritis patients treated with cyclophosphamide in the 20th and 21st centuries: a 23-year study

Comparing outcomes of biopsy-proven anti-neutrophil cytoplasmic autoantibody-associated glomerulonephritis patients treated with cyclophosphamide in the 20th and 21st centuries: a 23-year study

Association of Cigarette Smoking With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

Analysis of Antineutrophil Cytoplasm Antibody from 118 730 Patients in Tertiary Hospitals in Jiangxi Province, China

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