Pulmonary involvement of ANCA-associated vasculitis in adult Chinese patients

Zhou, Peining; Li, Zhiying; Gao, Li; Que, Chengli; Li, Haichao; Ma, Jing; Wang, Guangfa; Chen, Min

doi:10.1186/s12890-022-01829-y

Cited by 12 publications

(31 citation statements)

References 49 publications

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“…And the risk of infections was greatest in the first year [1,33] . In contrast to our immunosuppressive agents was an independent risk factor for infections [32] . The disagreement is probably caused by different duration from diagnosis to the infections.…”

Section: Discussioncontrasting

confidence: 77%

“…The disagreement is probably caused by different duration from diagnosis to the infections. Infections mainly occurred shortly after remission induction treatments in previous studies [32] . While the median time from diagnosis to infections was 39 weeks in our study.…”

Section: Discussionmentioning

confidence: 74%

“…Pulmonary involvement was regarded as a risk factor of infection [32] . Moreover, pulmonary infections exert burdens of death [30] .…”

Section: Discussionmentioning

confidence: 99%

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Characteristics and Prognosis of Microscopic Polyangiitis Patients with Diffuse Alveolar Hemorrhage and Interstitial Lung Disease

Zhang

Peng

et al. 2022

Chinese Medical Sciences Journal

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Objective To evaluate the clinical characteristics and prognostic predictors of patients with diffuse alveolar hemorrhage (DAH) and/or interstitial lung disease (ILD) secondary to microscopic polyangiitis (MPA) in a Chinese general hospital. MethodsWe retrospectively reviewed the medical records of MPA patients admitted to internal medicine departments between the year 2002 and 2012. The patients were divided into the ILD, DAH, DAH combined with ILD (DAHILD), and no pulmonary involvement (NPI) groups according to pulmonary involvement patterns. The clinical characteristics at diagnosis were analyzed. The risk factors associated with short-term death and long-term death were identified with Logistic regression and Cox analysis. ResultsFinally, 181 patients were enrolled in the research, of which 19 had DAH alone, 96 had ILD alone, 18 had DAH and DAH concurrently, and 48 had NPI. The median of serum creatine level in the DAH group was 449 μmol/L, was significantly higher than that in the ILD group (123 μmol/L, Nemenyi = -35.215, P = 0.045) and DAHILD group (359 μmol/L, Nemenyi = -43.609, P = 0.007). The median follow-up time was 67 (range: 1-199) months. Patients in the ILD group were elder than those in the DAH group (median value: 69 vs. 57 years; Nemenyi = 43.853, P = 0.005). The patients with both DAH and ILD had combined features of the two subtypes, and the highest mortality (72.2% at the end of follow-up). The elevated white blood cell count was a risk factor for short-term death (OR = 1.103, 95%CI 1.008-1.207, P = 0.032 for one month; OR = 1.103, 95%CI 1.026-1.186, P = 0.008 for one year).

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 74%

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Characteristics and Prognosis of Microscopic Polyangiitis Patients with Diffuse Alveolar Hemorrhage and Interstitial Lung Disease

Zhang

Peng

et al. 2022

Chinese Medical Sciences Journal

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“…AAV, ANCAassociated vasculitis; ILD, interstitial lung disease; NSIP, nonspecific interstitial pneumonia; OP, organizing pneumonia; UIP, usual interstitial pneumonia. 3 1.202 (0.406-3.560) 0.740 DLCO% pred. decline 3 1.436 (0.614-3.358) 0.404 DLCO/VA% pred.…”

Section: Discussionmentioning

confidence: 99%

“…decline 3 1.436 (0.614-3.358) 0.404 DLCO/VA% pred. decline 3 0.988 (0.921-1.059) 0.728 Rate of decline in FVC % pred. 3 3.167 (0.800-12.541) 0.101 Rate of decline in TLC% pred.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Interstitial Lung Disease and Prognosis in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Zhou

et al. 2023

Respiration

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Background: Interstitial lung disease (ILD) is a common pulmonary manifestation of antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Objectives: We aimed to clarify the clinical predictors of mortality in a cohort of patients with AAV-related ILD (AAV-ILD). Method: We retrospectively identified AAV-ILD patients seen at Peking University First Hospital from January 2010 to June 2020 and manually screened for study inclusion. Baseline computed tomography (CT) images were further classified as nonspecific interstitial pneumonia (NSIP), usual interstitial pneumonia (UIP), organizing pneumonia (OP), and unclassified ILD. Disease characteristics and other pulmonary findings including pulmonary function test and bronchoalveolar lavage (BAL) were also evaluated. Multivariable Cox regression analysis was performed to identify clinical predictors of mortality. Results: The cohort included 204 patients with AAV-ILD, 152 had UIP on CT (AAV-UIP), 39 had NSIP on CT (AAV-NSIP), 3 had OP, and 10 had unclassified ILD. Microscopic polyangiitis was more prevalent in patients with UIP, while granulomatosis with polyangiitis was more common in the NSIP and OP groups, and eosinophilic granulomatosis with polyangiitis was more frequent in patients with unclassified ILD. ILD diagnosis before AAV was more common in patients with either UIP or NSIP patterns. During the median follow-up of 40 months, 44 (21.6%) patients died. One- and 5-year overall survival rates were 88.2% (95% CI, 83.7–92.7%) and 81.0% (95% CI, 74.9–87.1%) for the entire cohort. Patients with UIP patterns had the worst prognosis, while those with NSIP patterns had the best long-term outcome. Specifically, patients with UIP patterns had an approximately 5-fold risk of death compared to those with NSIP. After controlling for potential confounding factors, we observed that each 10% increase in the BAL fluid neutrophil percentage was associated with nearly a 20% increased risk of death (HR 1.195, 95% CI 1.018–1.404). Conclusions: Clinical characteristics and survival differ between subgroups defined by CT patterns. BAL fluid neutrophilia is an independent predictor of mortality among AAV-ILD patients, and therefore, the clinical utility of BAL at the time of AAV diagnosis should be considered.

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Analysis of the risk factors for end‑stage renal disease and mortality in ANCA-associated vasculitis: a study from a single center of the Chinese Rheumatism Data Center

Guo

Zhang

et al. 2022

Clin Rheumatol

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Pulmonary involvement of ANCA-associated vasculitis in adult Chinese patients

Cited by 12 publications

References 49 publications

Characteristics and Prognosis of Microscopic Polyangiitis Patients with Diffuse Alveolar Hemorrhage and Interstitial Lung Disease

Characteristics and Prognosis of Microscopic Polyangiitis Patients with Diffuse Alveolar Hemorrhage and Interstitial Lung Disease

Patterns of Interstitial Lung Disease and Prognosis in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Analysis of the risk factors for end‑stage renal disease and mortality in ANCA-associated vasculitis: a study from a single center of the Chinese Rheumatism Data Center

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