Cinical and pathological characteristics of Chinese patients with antineutrophil cytoplasmic autoantibody associated systemic vasculitides: a study of 426 patients from a single centre

Chen, M; Yu, Feng; Y, Zhang; Zhao, Ming‐Hui

doi:10.1136/pgmj.2005.034215

Cited by 95 publications

(77 citation statements)

References 22 publications

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“…This is consistent with the main clinical departments (Renal Internal Medicine, Internal Medicine, and Respiratory Department of Rheumatology); the patients were admitted based on the primary diagnosis. The onset age, gender, and major organ damage distribution of patients were consistent with previous reports (Chen et al, 2005;Oh et al, 2009;Ahn et al, 2012). The clinical manifestations (including decreased fatigue, fever, and decrease in weight) of multi-system damage in MPO-AAV and routine laboratory abnormalities, which included increased total peripheral blood cell and neutrophil counts, anemia, and elevated ESR and CRP, all lack specificity.…”

Section: Discussionsupporting

confidence: 71%

“…The association of peri-nuclear ANCA (p-ANCA) with MPA and EGPA has been detected by indirect immunofluorescence (IIF). According to previous studies, the incidence of GPA in the European population is >60% (Reinhold-Keller et al, 2005), that of MPA in China and Japan is 79-83% (Chen et al, 2005;Fujimoto et al, 2011), and that of MPO-ANCA is as high as 59-94% (Oh et al, 2009;Ahn et al, 2012). Inducing AAV in an immunized animal model with MPO-ANCA or MPO antigen in a previous study (Xiao et al, 2002;Little et al, 2005;Roth et al, 2013) suggested that MPO-ANCA may play a pathogenic role in AAV.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, MPO-ANCA may be the main antibody associated with AAV in Chinese patients. MPO-AAV is not rare in China (Chen et al, 2005). However, it has received little attention, and the lack of awareness has led to delayed clinical diagnosis and treatment of this disease.…”

Section: Introductionmentioning

confidence: 99%

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Clinical analysis of patients with myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis

Shuai

Zhang

et al. 2015

Genet. Mol. Res.

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ABSTRACT. This prospective study analyzed the clinical characteristics of myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-associated vasculitis and explored the relationship between MPO-ANCA and clinical manifestations of the associated vasculitis in 132 p-ANCA and MPO-ANCA-positive patients (average age, 62.3 ± 14.8 years) who were initially diagnosed with ANCA-associated vasculitis. The p-ANCA and MPO-ANCA levels in peripheral blood were detected in all patients. Among these, 128 (97%) had microscopic polyangiitis (MPA), 3 (2.3%) had granulomatous polyangiitis, and 1 (0.7%) had eosinophilic granulomatous vasculitis. The average time of diagnosis was 10.2 ± 18 months; only 14 (10.6%) patients were diagnosed within 1 month. The main organs involved and the corresponding number of patients were: renal, 95 (72%); lung, 89 (67.4%); joints, 35 (26.5%); heart, 26 (19.7%); peripheral nerve, 23 (17.4%); skin rash, 14 (10.6%); and CNS, 13 (9.8%). Older patients were more likely to show lung involvement in the early disease stage, whereas the joints were involved mostly in the younger patients. The p-ANCA levels (mean titers, 1:60) were not correlated with disease activity and extent of organ (2015) involvement, and the MPO-ANCA levels were positively correlated with disease activity, but had no correlation with the extent of organ involvement. MPO-ANCA vasculitis is a common occurrence in China; it mainly involves the elderly and presents as clinical manifestations of MPA. However, the multiple organ damage is not specific leading to delay in diagnosis. MPO-ANCA may play a pathogenic role in the associated vasculitis, and the diverse clinical manifestations might be related with the different characteristics of MPO-ANCA.

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

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Clinical analysis of patients with myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis

Shuai

Zhang

et al. 2015

Genet. Mol. Res.

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“…Treatment protocols were previously described (19)(20)(21). The induction therapy included corticosteroids in combination with cyclophosphamide.…”

Section: Treatmentmentioning

confidence: 99%

Association of HLA Genes with Clinical Outcomes of ANCA-Associated Vasculitis

Chang

Luo

Zhou

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives The HLA system plays a central role in the distinction between self antigens and non-self antigens. This study aimed to investigate the association between HLA genes and the outcomes of patients with ANCA-associated vasculitis (AAV).Design, setting, participants, & measurements This study recruited 152 consecutive Chinese patients with AAV. The predictive value of the HLA alleles for renal outcome, response to treatment, and all-cause mortality were analyzed. ResultsThe proportion of patients with treatment failure was significantly higher in DRB1*0405-positive patients than in DRB1*0405-negative patients (41.7% versus 12.9%; P=0.008; corrected P=0.02). After adjusting for the other potential predictors, DRB1*0405 was still an independent predictor for the poor response to treatment (hazard ratio [HR], 5.91; 95% confidence interval [95% CI], 1.23-28.52; P=0.03). Renal survival was significantly worse in patients with DRB1*0405 than those without DRB1*0405 (P,0.001; corrected P,0.001). After adjusting for the other potential predictors, DRB1*0405 was still an independent predictor for ESRD (HR, 5.50; 95% CI, 2.18-13.88; P,0.001). The probability of all-cause mortality in patients with DPB1*0402 was significantly higher than those without DPB1*0402 (P=0.02; corrected P=0.04). After adjusting for the other potential predictors, DPB1*0402 was still an independent predictor for all-cause mortality (HR, 2.52; 95% CI, 1.21-5.28; P=0.01).Conclusions In AAV patients, DRB1*0405 might be an independent risk factor for the poor response to treatment and the deterioration of renal function, whereas DPB1*0402 might be an independent risk factor for all-cause mortality.

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“…Proteinase 3 (PR3) and myeloperoxidase (MPO) are two major target antigens of ANCA in AAV [1]. MPO is the most common target antigen of ANCA in Chinese patients with AAV [2][3][4]. Even in patients with a clinical picture of GPA, about 60% of them have ANCA directed to MPO [5], [6].…”

Section: Introductionmentioning

confidence: 99%

Epitope analysis of anti-myeloperoxidase antibodies in patients with ANCA-associated vasculitis

Gou

Chen

et al. 2013

La Presse Médicale

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Objective: Increasing evidences have suggested the pathogenic role of anti-neutrophil cytoplasmic antibodies (ANCA) directing myeloperoxidase (MPO) in ANCA-associated vasculitis (AAV). The current study aimed to analyze the association between the linear epitopes of MPO-ANCA and clinicopathological features of patients with AAV.Methods: Six recombinant linear fragments, covering the whole length amino acid sequence of a single chain of MPO, were produced from E.coli. Sera from 77 patients with AAV were collected at presentation. 13 out of the 77 patients had coexistence of serum anti-GBM antibodies. Ten patients also had sequential sera during follow up. The epitope specificities were detected by enzyme-linked immunosorbent assay using the recombinant fragments as solid phase ligands.Results: Sera from 45 of the 77 (58.4%) patients with AAV showed a positive reaction to one or more linear fragments of the MPO chain. The Birmingham Vasculitis Activity Scores and the sera creatinine were significantly higher in patients with positive binding to the light chain fragment than that in patients without the binding. The epitopes recognized by MPO-ANCA from patients with co-existence of serum anti-GBM antibodies were mainly located in the N-terminus of the heavy chain. In 5 out of the 6 patients, whose sera in relapse recognize linear fragments, the reactivity to linear fragments in relapse was similar to that of initial onset.

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Cinical and pathological characteristics of Chinese patients with antineutrophil cytoplasmic autoantibody associated systemic vasculitides: a study of 426 patients from a single centre

Cited by 95 publications

References 22 publications

Clinical analysis of patients with myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis

Clinical analysis of patients with myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis

Association of HLA Genes with Clinical Outcomes of ANCA-Associated Vasculitis

Epitope analysis of anti-myeloperoxidase antibodies in patients with ANCA-associated vasculitis

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