Are environmental factors important in primary systemic vasculitis?: A case–control study

Abstract

Objective. To investigate the association between primary systemic vasculitis (PSV) and environmental risk factors.Methods. Seventy-five PSV cases and 273 controls (220 nonvasculitis, 19 secondary vasculitis, and 34 asthma controls) were interviewed using a structured questionnaire. Factors investigated were social class, occupational and residential history, smoking, pets, allergies, vaccinations, medications, hepatitis, tuberculosis, and farm exposure in the year before symptom onset (index year). The Standard Occupational Classification 2000 and job-exposure matrices were used to assess occupational silica, solvent, and metal exposure. Stepwise multiple logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval Conclusion. A significant association between farming and PSV has been identified for the first time. Results also support previously reported associations with silica, solvents, and allergy.The primary systemic vasculitides (PSV) are a group of relatively rare diseases of unknown etiology (1). A number of potential environmental risk factors have been reported. Systemic vasculitis has been associated with exposure to particulate silica (e.g., quartz, granite, sandstone, and grain dust) (2-5). There has been conflicting evidence regarding a link between occupational exposure to hydrocarbons (e.g., paints, glues) and Wegener's granulomatosis (WG) and microscopic polyangiitis (MPA), and the association with glomerulonephritis is stronger (6-8). A case-control study carried out at the National Institutes of Health (NIH) revealed an association with exposure to fumes or particulates and pesticides in patients with WG compared with healthy or rheumatic disease controls but not respiratory disease

An Elderly Patient with Diabetic Nephropathy Complicated by ANCA-associated Nephritis

“…One report shows a higher prevalence of smoking in patients with ANCA-associated nephritis (19). On the other hand, there are studies showing no association between smoking status and ANCA-associated vasculitis (20,21). Thus, we could not determine whether the smoking habit influenced ANCA positivity in the present case.…”

Wegener’s granulomatosis and environmental factors in Western Montana

“…2 However, descriptive epidemiological studies identifying geographic variation, and other studies identifying seasonal differences in WG onset, have suggested that environmental factors also play a role in WG etiology. [2][3][4][5][6][7][8][9][10] Environmental exposures can affect ANCA production. For example, persons with chronic exposure to ambient silica more commonly have elevated serum ANCA titers with MPO antibodies.…”

“…3,4 In addition, the results of several case-control studies have suggested that occupational history of inhaled ambient silica is a risk factor for developing AAV. [5][6][7][8] Other case-control studies have observed an association between exposure to metals, solvents, and pesticides and AAV occurrence. 8,11,12 While studies have identified the contribution of smoking to the development of rheumatoid factor and seropositive rheumatoid arthritis, studies of other immune-mediated disorders have failed to identify a clear influence of cigarette smoking on their development.…”

Churg-Strauss Syndrome or Eosinophilic Granulomatosis with Polyangiitis

“…Although studied in a small number of patients, exposure to silica particles has also been considered a risk factor for EGPA, as it was for other VAA [27,28].…”