Predictors of Poor Outcome in ANCA-Associated Vasculitis (AAV)

Vega, Luis E.; Espinoza, Luis R.

doi:10.1007/s11926-016-0619-3

Cited by 16 publications

(4 citation statements)

References 36 publications

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“…GPA patients with renal involvement had higher PLR levels than those without renal involvement and PLR was significantly correlated with GFR. Newer biomarkers detected in urine or blood could greatly assist with diagnosis, disease activity assessment, and prognosis of patients with GPA; however, at present there is a need for prospective and longitudinal studies followed by validation in different groups of GPA patients to confirm their clinical value [34].…”

Section: Discussionmentioning

confidence: 99%

Platelet/lymphocyte ratio and mean platelet volume in patients with granulomatosis with polyangiitis

et al. 2019

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Background: Granulomatosis with polyangiitis (GPA) is a granulomatous necrotizing vasculitis with high morbidity and mortality. Anti-neutrophil cytoplasmic antibody is a valuable diagnostic marker, however its titer lacks predictive value for the severity of organ involvement. Platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) has been regarded as a potential marker in assessing systemic inflammation. We aimed to explore the value of PLR and MPV in the assessment of disease activity and manifestations of disease in GPA. Methods: 56 newly diagnosed GPA patients and 53 age-sex matched healthy controls were included in this retrospective and cross-sectional study with comparative group. Complete blood count was performed with Backman Coulter automatic analyzer, erythrocyte sedimentation rate (ESR) with Westergen method and C-reactive protein (CRP) levels with nephelometry. The PLR was calculated as the ratio of platelet and lymphocyte counts. Result: Compared to control group, ESR, CRP and PLR were significantly higher and MPV significantly lower in GPA patients. In patients group, PLR was positively correlated with ESR and CRP (r = 0.39, p = 0.005 and r = 0.51, p < 0.001, respectively). MPV was negatively correlated with ESR and CRP (r = − 0.31, p = 0.028 and r = − 0.34 p = 0.014, respectively). Patients with renal involvement had significantly higher PLR than patients without renal involvement (median:265.98, IQR:208.79 vs median:180.34 IQR:129.37, p = 0.02). PLR was negatively correlated with glomerular filtration rate (r = − 0.27, p = 0.009). A cutoff level of 204 for PLR had 65.6% sensitivity and 62.5 specificity to predict renal involvement. Conclusion: PLR exhibit favorable diagnostic performance in predicting renal involvement in patients with GPA.

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Section: Discussionmentioning

confidence: 99%

Platelet/lymphocyte ratio and mean platelet volume in patients with granulomatosis with polyangiitis

et al. 2019

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“…Conversely, patients with ANCA positivity exhibited a significantly higher median TGF at AAV diagnosis than those with ANCA negativity ( Figure 1 ). Given that pathogenic ANCA participates in both phases, the neutrophil priming and activation phases in the pathogenesis of AAV [ 23 , 24 ], the following hypotheses can be put forward: (i) TGF at AAV diagnosis may reflect the amount of pathogenic ANCA at AAV diagnosis; (ii) the amount of ANCA at AAV diagnosis may affect the degree of inflammation in the earliest phase of AAV before major organ damage [ 25 ]; (iii) the degree of inflammation in the earliest phase of AAV before major organ damage may be associated with an increase in the rates of all-cause mortality owing to the increased requirement of immunosuppressive drugs and the frequent earlier major organ failure; and, (iv) therefore, TGF at AAV diagnosis may forecast all-cause mortality during the disease course in AAV patients ( Figure 4 ).…”

Section: Discussionmentioning

confidence: 99%

Total Globulin Fraction at Diagnosis Could Forecast All-Cause Mortality during the Disease Course in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Ahn

Song

et al. 2023

JCM

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Total globulin fraction (TGF) is calculated by subtracting serum albumin levels from serum total protein levels. The present study examined whether TGF at diagnosis could forecast all-cause mortality during the disease course in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The present study included 283 patients with AAV. The variables at AAV diagnosis such as demographic data, AAV-specific data including the Birmingham vasculitis activity score (BVAS), five-factor score (FFS), and laboratory data including ANCA, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were collected. The number of deceased patients during the follow-up duration based on all-cause mortality was counted. The median age of the 283 AAV patients was 60 years, and 35.7% were men. ANCAs were detected in 228 patients, and the median TGF was 2.9. A total of 39 patients (13.8%) died within a median follow-up duration of 46.9 months. TGF at AAV diagnosis was significantly correlated with ESR and CRP rather than AAV activity. Patients with ANCA positivity exhibited a significantly higher median TGF at AAV diagnosis than those without. Patients with TGF ≥ 3.1 g/dL at AAV diagnosis exhibited a significantly lower cumulative survival rate than those without. Furthermore, in the multivariable Cox hazards model analysis, TGF ≥ 3.1 g/dL (hazard ratio 2.611) was independently associated with all-cause mortality, along with age, male sex, and body mass index. The present study is the first to demonstrate that TGF at AAV diagnosis can forecast all-cause mortality during the disease course in AAV patients.

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“…WG has been reported to be a type of angiitis associated with ANCA, in particular cytoplasm ANCA (c-ANCA) (30). It was reported that the serum c-ANCA levels during the active phase of WG are elevated in 90% of patients (31). In the present study, 84.38% patients were ANCA-positive and 74.07% patients were positive for elevated c-ANCA levels (20/27); However other diseases, including polyarteritis nodosa, systemic lupus erythematosus, anaphylactoid purpura and Kawasaki disease may also present as c-ANCA-positive (9).…”

Section: Discussionmentioning

confidence: 99%

Thoracic manifestation of Wegener's granulomatosis: Computed tomography findings and analysis of misdiagnosis

2018

Exp Ther Med

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The aim of the present study was to investigate the computed tomography (CT) manifestations of Wegener granulomatosis (WG) in the chest and potential reasons for misdiagnosis. Conventional CT scans and clinical data of 45 patients with WG were retrospectively analyzed. Patients typically presented with multiple system involvement, primarily in the upper and lower respiratory tract. The incidence of thoracic involvement was 75.56% (34/45). Radiographic features were varied between cases in the present study, with the most common features being numerous cavitary nodules and masses in the lungs. Cavitations were usually irregular, with uneven wall thickness, partial centrality, fuzzy inner edges and piecemeal necrosis. These results indicate that WG typically has multiple system involvement, with the chest being most prominent. Multiple variable-sized cavitary nodules with irregular edges and piecemeal necrosis were the most notable features revealed using CT scanning; however, in order to give a definitive diagnosis, biopsies should be performed.

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Predictors of Poor Outcome in ANCA-Associated Vasculitis (AAV)

Cited by 16 publications

References 36 publications

Platelet/lymphocyte ratio and mean platelet volume in patients with granulomatosis with polyangiitis

Platelet/lymphocyte ratio and mean platelet volume in patients with granulomatosis with polyangiitis

Total Globulin Fraction at Diagnosis Could Forecast All-Cause Mortality during the Disease Course in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Thoracic manifestation of Wegener's granulomatosis: Computed tomography findings and analysis of misdiagnosis

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