Cancer-associated vasculitides: a single-centre case series

Do, Hyunsue; Pyo, Jung Yoon; Ahn, Sung Soo; Song, Jaeyong; Park, Yong Bum; Lee, Sang Won

doi:10.1007/s10067-022-06363-0

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…On the other hand, in a recent single-center study, coexistence of cancer and vasculitis was found in 0.034% of patients with cancers: GPA was the second most frequent type of vasculitis associated with cancers after Behçet's disease [24].…”

Section: Discussionmentioning

confidence: 86%

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Pulmonary pattern in systemic vasculitis: granulomatosis, lung cancer or both?

Smiyan

Bernstein²,

Izhik³

et al. 2022

Reumatologia

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As clinical manifestations of systemic vasculitides share many common features with other conditions, the rate of diagnostic errors and delayed diagnoses is high. Hence we performed an analysis of the available data regarding misdiagnosis of vasculitis as lung cancer and vice versa, as well as coexistence of vasculitis and lung cancer. The present case-based review highlights the diagnostic challenges encountered when granulomatosis with polyangiitis (GPA) mimics lung cancer. The importance of a multidisciplinary team approach to patients with pulmonary involvement and multisystem manifestations is essential for appropriate planning of further diagnostic steps and for minimizing the delay in correct diagnosis and treatment. In the present case, although computed tomography raised suspicion for lung cancer, further biopsies and laboratory screening for systemic vasculitides rejected malignancy and confirmed the diagnosis of GPA.

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Section: Discussionmentioning

confidence: 86%

“…Of note, lung cancer ranked ninth among cancers associated with vasculitides, preceded by thyroid cancer (the most common type of malignancy), lymphoma, stomach cancer, breast cancer, brain tumors, leukemia, hepatocellular carcinoma and prostate cancer [24].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary pattern in systemic vasculitis: granulomatosis, lung cancer or both?

Smiyan

Bernstein²,

Izhik³

et al. 2022

Reumatologia

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“…The inclusion criteria were i) the first classification of SSc was made at the Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, from June 2004 to November 2020; ii) fulfilment of the classification criteria for SSc that were collaboratively proposed by the ACR and EULAR in 2013 (the 2013 ACR/EULAR criteria for SSc) [ 12 ]; iii) presence of well-written medical records sufficient for collecting and analyzing clinical data at diagnosis and during follow-up; iv) presence of ANCA test results; and v) presence of signs suggestive of small- or medium-vessel vasculitis at SSc diagnosis. The exclusion criteria were i) the presence of concomitant serious medical conditions mimicking SSc and AAV, such as malignancies and severe infectious diseases requiring hospitalization [ 13 , 14 ]; ii) presence of autoimmune diseases affecting ANCA false positivity, such as inflammatory bowel diseases or primary sclerosing cholangitis [ 15 ]; iii) presence of administered drugs provoking ANCA false positivity, such as propylthiouracil and hydralazine [ 16 , 17 ]; iv) patients previously diagnosed with SSc-AAV-OS; and v) medical history of renal crisis that could not be differentiated from glomerulonephritis resulting from SSc-AAV-OS [ 4 , 5 ].…”

Section: Methodsmentioning

confidence: 99%

Overlap syndrome of systemic sclerosis with antineutrophil cytoplasmic antibody-associated vasculitis according to 2022 ACR/EULAR criteria

Ha,

Pyo,

Ahn

et al. 2024

Korean J Intern Med

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Background/Aims: This study applied the 2022 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) criteria for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) to patients with systemic sclerosis (SSc) and investigated the frequency of overlap syndrome of SSc and AAV (SSc-AAV-OS).Methods: Among the 232 patients diagnosed with SSc, 105 with signs suggestive of small- or medium-vessel vasculitis, which were defined as the present of interstitial lung disease (ILD), peripheral neuropathy, or suspected renal vasculitis, were included in this study and analyzed.Results: Among the 105 SSc patients, the detection rate of ANCA was 19.0%. When the 2022 ACR/EULAR criteria were applied, the frequency of SSc-AAV-OS was 20.0%, which was much higher than 1.7% reported with previous criteria for AAV. ANCA positivity contributed to the reclassification of SSc-AAV-OS more than ANCA negativity in SSc patients with signs suggestive of small- or medium-vessel vasculitis.Conclusions: The frequency of SSc-AAV-OS in SSc patients with signs suggestive of small- or medium-vessel vasculitis at diagnosis was 20.0%. Therefore, we suggest that physicians should perform ANCA tests in SSc patients exhibiting signs suggestive of small- or medium-vessel vasculitis and apply the new criteria for AAV.

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Clinical Significance of Overlap Syndrome of Histologically Confirmed Lupus Nephritis with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Whang,

Ha,

Park

et al. 2024

JCM

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Objectives: We applied the 2022 American College of Rheumatology/ European Alliance of Association for Rheumatology (ACR/EULAR) criteria for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) to patients histologically diagnosed with lupus nephritis (LN) to investigate the overall rate of and initial contributing factors to the reclassification of overlap syndrome of LN with AAV (OS-LN-AAV). Methods: We retrospectively reviewed the medical records of 1292 patients with systemic lupus erythematosus (SLE) and included 164 patients with LN in this study. Patient demographics, SLE manifestations, LN classes, and laboratory data, including ANCA levels, were recorded. All-cause mortality and end-stage kidney disease (ESKD) were evaluated as poor outcomes. Results: The median age of the 164 patients was 37.0 years, and 12.2% were men. The overall reclassification rate was 37.8%, of which 34.1% and 3.7% of the patients were reclassified as having OS-LN-microscopic polyangiitis and OS-LN-granulomatosis with polyangiitis (GPA), respectively, but none as having eosinophilic GPA. ANCA positivity and AAV-suggesting lung lesions were major contributors to OS-LN-AAV reclassification. When patients were compared based on OS-LN AAV reclassification, ANCA positivity and myeloperoxidase-ANCA (or P-ANCA) positivity favoured for OS-LN-AAV reclassification, whereas oral ulcers did not. However, OS-LN-AAV reclassification did not affect all-cause mortality or ESKD. Conclusions: This is the first study demonstrating a 37.8% reclassification rate in patients histologically diagnosed with LN using the 2022 ACR/EULAR criteria for AAV. Furthermore, it was also the first to reveal ANCA positivity and AAV-suggesting lung lesions as major contributors to OS-LN-AAV reclassification.

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Cancer-associated vasculitides: a single-centre case series

Cited by 3 publications

References 23 publications

Pulmonary pattern in systemic vasculitis: granulomatosis, lung cancer or both?

Pulmonary pattern in systemic vasculitis: granulomatosis, lung cancer or both?

Overlap syndrome of systemic sclerosis with antineutrophil cytoplasmic antibody-associated vasculitis according to 2022 ACR/EULAR criteria

Clinical Significance of Overlap Syndrome of Histologically Confirmed Lupus Nephritis with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

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