Prevalence and prognostic relevance of cardiac involvement in ANCA-associated vasculitis: Eosinophilic granulomatosis with polyangiitis and granulomatosis with polyangiitis

Hazebroek, Mark; Kemna, Michael J.; Schalla, Simon; Wijk, Sandra Sanders‐van; Gerretsen, Suzanne; Dennert, Robert; Merken, Jort J.; Kuznetsova, Tatiana; Staessen, Jan A.; Rocca, Hans‐Peter Brunner‐La; Paassen, Pieter van; Tervaert, Jwc; Heymans, Stéphane

doi:10.1016/j.ijcard.2015.06.087

Cited by 111 publications

(85 citation statements)

References 60 publications

(112 reference statements)

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“…Ocular involvement was less frequent in Northeastern Brazil (n = 1; 4%) than in New Zealand (n = 15; 20%) [11]. The observed frequency of cardiac involvement (16%) matched the findings of other epidemiological studies but was lower than the frequency reported in case studies (25-46%) [30]. CNS and gastrointestinal tract involvement was rare, as in most other studies [13,29].…”

Section: Discussionsupporting

confidence: 66%

Granulomatosis with polyangiitis in Northeastern Brazil: study of 25 cases and review of the literature

et al. 2018

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Background: Little has been published about the epidemiology of Granulomatosis with polyangiitis (GPA) in South America, especially in the intertropical zone, and no epidemiological data from Brazil are available. The purpose of the present study was to draw a clinical and demographic profile of GPA patients living in Northeastern Brazil based on laboratory, histological and imaging findings, and evaluate the frequency of organic involvement.Methods: Clinical, epidemiological and treatment data of GPA patients were collected retrospectively and compared with the literature.Results: The cohort included 25 GPA patients (84% female) aged 45.8 ± 16.1 years. Renal and ear-nose-throat (ENT) manifestations were the most common (both 64%). One third (32%) of the patients had 24-h proteinuria > 1 g, 50% had creatinine clearance < 50 mL/min at the time of diagnosis, and 33% had recurrent kidney damage during disease progress. The affected organs included lungs (60%), joints (44%), skin (32%), peripheral nervous system (28%), eyes (28%) and heart (16%). ENT involvement (n = 16/64%) was less frequent in our region than in São Paulo (n = 115/85.8%). Renal (n = 16/64%) and pulmonary (n = 15/60%) involvement was less frequent in our region than in the U.K. (renal n = 30/90%; pulmonary n = 28/84.8%).

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Section: Discussionsupporting

confidence: 66%

Granulomatosis with polyangiitis in Northeastern Brazil: study of 25 cases and review of the literature

et al. 2018

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“…However, studies concerning cardiovascular involvement are hampered due to differences in applied diagnostic methods and lack of a clear definition of cardiovascular involvement due to vasculitis. In a prospective study with extensive cardiac screening including cardiac magnetic resonance imaging, it has been shown that 61% of patients with GPA have cardiac involvement, independent of clinical symptoms [46]. In a study with 502 patients, it was shown that ANCA specificity predicted relapses better than clinical diagnosis based on CHCC or EMA classification [29].…”

Section: Patient Classifications -Based On the Chance To Relapsementioning

confidence: 99%

Maintaining remission in patients with granulomatosis with polyangiitis or microscopic polyangiitis: the role of ANCA

Kemna¹,

Paassen²,

Damoiseaux³

et al. 2017

Expert Opinion on Orphan Drugs

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Introduction: Granulomatosis with Polyangiitis (GPA; formerly Wegener's) and Microscopic Polyangiitis (MPA) are inflammatory disease entities affecting small to medium vessels. They are characterized by the presence of anti-neutrophil cytoplasmic antibodies (ANCA) and are frequently grouped together with Eosinophilic Granulomatosis with Polyangiitis (EGPA; formerly Churg Strauss Syndrome) under the term ANCA-associated Vasculitis (AAV). Due to effective immunosuppressive therapy that was introduced more than 45 years ago, AAV has become a chronic disease in which relapses occur frequently during maintenance treatment or later on after all immunosuppressive therapy is stopped. Since relapses are associated with morbidity and mortality, early detection and prevention of relapses is of great importance. Areas covered: This review focuses on the potential strategies to guide maintenance therapy in patients with GPA or MPA, with an emphasis on patient classifications and the role of serial ANCA measurements. Expert opinion: Risk factors for relapses, e.g., genetic background of the patient, have been studied during the last three decades. Only few of these risk factors directly influence the management of patients. One potentially important factor that may influence therapeutic decisions in AAV patients is serial measurement of ANCA. Recently, it became clear that serial ANCA measurement is an attractive approach in AAV patients with (a history of) capillaritis, e.g., renal involvement or alveolar haemorrhage, but not in patients with more limited disease. Whether ANCA rises can be used to guide therapy andhence-to prevent relapses has been a great debate during the last three decades. At present, we conclude that small studies do support such an approach but that these findings require further validation in larger randomized clinical trials. ARTICLE HISTORY

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“…Estimates of the frequency of cardiac involvement in GPA vary widely, with a North American study reporting a rate of 33.3% and no association with a higher rate of relapse or premature death [16], while a European study reported cardiac involvement in 46% of GPA patients assessed with electrocardiography and echocardiography, along with increased all-cause and cardiovascular mortality [18].…”

Section: Cardiac Manifestation In Granulomatosis With Polyangiitismentioning

confidence: 99%

Cardiac manifestations in antineutrophil cytoplasmic autoantibody (ANCA) — associated vasculitides

Życińska

Borowiec

2016

Kardiol Pol

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Prevalence and prognostic relevance of cardiac involvement in ANCA-associated vasculitis: Eosinophilic granulomatosis with polyangiitis and granulomatosis with polyangiitis

Cited by 111 publications

References 60 publications

Granulomatosis with polyangiitis in Northeastern Brazil: study of 25 cases and review of the literature

Granulomatosis with polyangiitis in Northeastern Brazil: study of 25 cases and review of the literature

Maintaining remission in patients with granulomatosis with polyangiitis or microscopic polyangiitis: the role of ANCA

Cardiac manifestations in antineutrophil cytoplasmic autoantibody (ANCA) — associated vasculitides

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