Clinical Characteristics and Outcomes of Patients With ANCA-Associated Vasculitides in a Colombian Hospital

Abstract

Background/Objective: Antineutrophil cytoplasmic antibody-associated vasculitides (AAVs) are uncommon systemic autoimmune diseases, of which few reports exist in Latin America. Our aim was to examine AAV evaluated in a high-complexity hospital in southwestern Colombia, with emphasis in severe forms. Methods:A medical records review study of 67 patients was performed, and data were collected from electronic registries. Moderate and severe AAVs were defined as the presence of life-threatening complications, unfavorable Birmingham Vasculitis Activity Score outcomes, and hospitalization requirements at the time of diagnosis and by the last follow-up, between 2011 and 2019. Clinical manifestations, treatment, and outcomes were evaluated. The AAV subtypes were compared.Results: A total of 67 cases were included. The majority were female (n = 44, 65.67%), and the median age was 52 (40-64) years. Granulomatosis with polyangiitis (GPA) was the most frequent with 42 patients (62.68%), followed by microscopic polyangiitis (MPA) and eosinophilic GPA, with 15 patients (22.38%) and 10 patients (14.92%), respectively. Forty-four patients (65.67%) presented pulmonary symptoms. The highest Birmingham Vasculitis Activity Score corresponded to MPA, with 21 (12-25) points. Fifteen patients (22.4%) were admitted to the intensive care unit throughout the course of the disease, of whom 10 had GPA. The longest stay and duration of mechanical ventilation were seen in MPA. The principal treatments were corticosteroids and cyclophosphamide, and the main outcome was end-stage renal disease. Conclusions:In this cohort of AAV, most of cases corresponded to GPA, and pulmonary manifestations were the most common. Microscopic polyangiitis was the more severe subtype as it showed worse impairment in clinical characteristics and intensive care unit requirements.

Childhood-Onset ANCA- Associated Vasculitis: single center experience from Central California

“…There was a significant female preponderance, noted in other pediatric studies as well [ 5 , 9 , 10 , 27 ]. Studies from Latin America have also observed a female predominance in adult ANCA associated vasculitis [ 14 , 29 ]. Meanwhile in several adult studies, AAV has been noted to be more frequent in males than in females [ 7 , 30 ].…”

Measurement of superoxide dismutase: Clinical usefulness for patients with anti-neutrophil cytoplasmic antibody-associated vasculitis

“…Multiple organ system involvement is common in AAV, especially the lung and kidney, with resultant alveolar hemorrhage, acute renal failure, and a high risk of death [2,3]. Due to differences in clinical manifestations of AAV, many patients have acute onset and rapid progression of the disease, which often brings di culties to disease assessment [4]. Erythrocyte sedimentation rate (ESR), C reactive protein (CRP) levels, and Birmingham Vasculitis Activity Score (BVAS), as well as other biomarkers are commonly used to evaluate disease activity [5].…”