Predictive value of antineutrophil cytoplasmic antibodies in small-vessel vasculitis

Détails

ID Serval
serval:BIB_013FF66311DB
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Predictive value of antineutrophil cytoplasmic antibodies in small-vessel vasculitis
Périodique
Journal of Rheumatology
Auteur(s)
Lurati-Ruiz F., Spertini F.
ISSN
0315-162X (Print)
Statut éditorial
Publié
Date de publication
2005
Volume
32
Numéro
11
Pages
2167-72
Notes
Journal Article
Résumé
OBJECTIVE:. The predictive value of antineutrophil cytoplasmic antibodies (ANCA) as markers of clinical activity of small vessel vasculitis is controversial. We reviewed the outcome of patients with ANCA-associated vasculitis from a single center and evaluated the predictive value of ANCA as markers of relapse. METHODS: The medical history of all consecutive patients with ANCA-associated vasculitis followed at our outpatient clinic was retrospectively reviewed. ANCA were monitored by immunofluorescence and by ELISA (antiproteinase 3 and antimyeloperoxidase). RESULTS: Twenty-three patients with Wegener's granulomatosis and 13 with microscopic polyangiitis were followed for a median period of 5 years (1 mo-16 yrs). Most patients were treated with combined corticosteroids and cyclophosphamide. In the Wegener's granulomatosis group, remission was obtained in 21 of 23 patients (91%), within 4-48 weeks (median 7.5); relapses occurred in 74%. In the microscopic polyangiitis group, remission was obtained in all patients within 3-38 weeks (median 8); relapses occurred in 33%. In contrast to persistently (> 6 mo) elevated ANCA titers, which were not significantly associated with disease relapse, the predictive value of an acute rise in ANCA titers was strongly associated with the magnitude of the increase. CONCLUSION: Our study demonstrates the weak predictive value of persistently elevated ANCA titers, in contrast to acute rises in ANCA titers. Although an acute rise in ANCA titers may help in a decision whether to introduce immunosuppressive therapy, the final decision has to be based on both clinical and laboratory markers.
Mots-clé
Adolescent Adult Aged Aged, 80 and over Antibodies, Antineutrophil Cytoplasmic/blood/*diagnostic use Female Humans Immunosuppressive Agents/administration & dosage/adverse effects Male Microcirculation Middle Aged Predictive Value of Tests Recurrence Remission Induction Retrospective Studies Wegener Granulomatosis/*diagnosis/drug therapy/*immunology
Pubmed
Web of science
Création de la notice
25/01/2008 16:20
Dernière modification de la notice
20/08/2019 13:23
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