基于抗pr3 /MPO血清学的anca相关血管炎分类和相关结果:来自三级保健中心的前瞻性研究

Amrita Journal of Medicine Pub Date : 2022-07-01 DOI:10.4103/amjm.amjm_19_22

Gayatri Ekbote, N. Negalur, D. Tanna, M. Bindroo, D. Raval, S. Bajad, Rajiva Gupta, W. Kazi

{"title":"基于抗pr3 /MPO血清学的anca相关血管炎分类和相关结果:来自三级保健中心的前瞻性研究","authors":"Gayatri Ekbote, N. Negalur, D. Tanna, M. Bindroo, D. Raval, S. Bajad, Rajiva Gupta, W. Kazi","doi":"10.4103/amjm.amjm_19_22","DOIUrl":null,"url":null,"abstract":"Introduction: Diagnosis and management of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a challenge for all. Overlapping features in granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) make diagnosis sometimes difficult. We aimed to classify clinical features and outcomes of proven AAV according to their serology, viz., anti-PR3/myeloperoxidase (MPO) by the enzyme-linked immunosorbent assay (ELISA). Materials and Methods: This was a prospective observational study of a total of 66 patients. This study included all consequent (old and new) AAV patients visiting a tertiary care center in northern India from August 2012 to June 2018. Patients were followed up for a minimum of 6 months. ANCA was done by both immunofluorescence assay and ELISA. Results and Conclusion: When compared, serological classification yielded findings similar to clinical counterparts [PR3/MPO vs. GPA/MPA]. The majority [80.3%] of patients were PR3-positive and were GPA clinically. Lung involvement was common in the PR3 group; however, there was no significant difference between the two groups [viz., PR3 and MPO, P = 0.18]. ENT involvement was significantly higher in the PR3 group when compared with the MPO group [P-value=0.009]. The difference in renal involvement in both the groups was not significant [P = 0.28]. Renal biopsy findings were similar in both the PR3/MPO groups. The median follow-up period was 18 vs. 12 months in the PR3 and MPO groups, respectively. Relapse was significantly higher in the PR3 group [P = 0.017]. The PR3 group significantly required rituximab for second induction treatment [P = 0.028]. Eight patients (12.12%) died during the study period. There was no significant difference in mortality, and there was permanent organ damage in both the PR3 and MPO groups. Autoantibody-based classification is supplemental to the clinical segregation of AAV phenotypes.","PeriodicalId":138060,"journal":{"name":"Amrita Journal of Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Classifying ANCA-associated vasculitis and correlating outcomes based on anti-PR3/MPO serology: A prospective study from a tertiary care center\",\"authors\":\"Gayatri Ekbote, N. Negalur, D. Tanna, M. Bindroo, D. Raval, S. Bajad, Rajiva Gupta, W. Kazi\",\"doi\":\"10.4103/amjm.amjm_19_22\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: Diagnosis and management of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a challenge for all. Overlapping features in granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) make diagnosis sometimes difficult. We aimed to classify clinical features and outcomes of proven AAV according to their serology, viz., anti-PR3/myeloperoxidase (MPO) by the enzyme-linked immunosorbent assay (ELISA). Materials and Methods: This was a prospective observational study of a total of 66 patients. This study included all consequent (old and new) AAV patients visiting a tertiary care center in northern India from August 2012 to June 2018. Patients were followed up for a minimum of 6 months. ANCA was done by both immunofluorescence assay and ELISA. Results and Conclusion: When compared, serological classification yielded findings similar to clinical counterparts [PR3/MPO vs. GPA/MPA]. The majority [80.3%] of patients were PR3-positive and were GPA clinically. Lung involvement was common in the PR3 group; however, there was no significant difference between the two groups [viz., PR3 and MPO, P = 0.18]. ENT involvement was significantly higher in the PR3 group when compared with the MPO group [P-value=0.009]. The difference in renal involvement in both the groups was not significant [P = 0.28]. Renal biopsy findings were similar in both the PR3/MPO groups. The median follow-up period was 18 vs. 12 months in the PR3 and MPO groups, respectively. Relapse was significantly higher in the PR3 group [P = 0.017]. The PR3 group significantly required rituximab for second induction treatment [P = 0.028]. Eight patients (12.12%) died during the study period. There was no significant difference in mortality, and there was permanent organ damage in both the PR3 and MPO groups. Autoantibody-based classification is supplemental to the clinical segregation of AAV phenotypes.\",\"PeriodicalId\":138060,\"journal\":{\"name\":\"Amrita Journal of Medicine\",\"volume\":\"18 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Amrita Journal of Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/amjm.amjm_19_22\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Amrita Journal of Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/amjm.amjm_19_22","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

摘要

抗中性粒细胞细胞质抗体(ANCA)相关血管炎(AAV)的诊断和治疗对所有人都是一个挑战。肉芽肿合并多血管炎(GPA)和镜下多血管炎(MPA)的重叠特征有时使诊断变得困难。我们的目的是根据AAV的血清学，即通过酶联免疫吸附试验(ELISA)对抗pr3 /髓过氧化物酶(MPO)进行临床特征和结果分类。材料和方法:这是一项前瞻性观察性研究，共纳入66例患者。本研究包括2012年8月至2018年6月在印度北部三级医疗中心就诊的所有继发(新老)AAV患者。患者随访时间至少为6个月。采用免疫荧光法和ELISA法进行ANCA检测。结果与结论:血清学分类结果与临床结果相似[PR3/MPO vs. GPA/MPA]。绝大多数(80.3%)患者pr3阳性，临床表现为GPA。PR3组肺部受累较为常见;但两组间无显著差异[即PR3与MPO, P = 0.18]。与MPO组相比，PR3组耳鼻喉受累程度明显高于MPO组[p值=0.009]。两组肾脏受累程度差异无统计学意义[P = 0.28]。PR3/MPO组的肾活检结果相似。PR3组和MPO组的中位随访时间分别为18个月和12个月。PR3组复发率明显高于对照组[P = 0.017]。PR3组对利妥昔单抗二次诱导治疗的需求显著[P = 0.028]。8例患者(12.12%)在研究期间死亡。PR3组和MPO组的死亡率无显著差异，且均存在永久性器官损伤。基于自身抗体的分类是对AAV表型临床分离的补充。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Classifying ANCA-associated vasculitis and correlating outcomes based on anti-PR3/MPO serology: A prospective study from a tertiary care center

Introduction: Diagnosis and management of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a challenge for all. Overlapping features in granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) make diagnosis sometimes difficult. We aimed to classify clinical features and outcomes of proven AAV according to their serology, viz., anti-PR3/myeloperoxidase (MPO) by the enzyme-linked immunosorbent assay (ELISA). Materials and Methods: This was a prospective observational study of a total of 66 patients. This study included all consequent (old and new) AAV patients visiting a tertiary care center in northern India from August 2012 to June 2018. Patients were followed up for a minimum of 6 months. ANCA was done by both immunofluorescence assay and ELISA. Results and Conclusion: When compared, serological classification yielded findings similar to clinical counterparts [PR3/MPO vs. GPA/MPA]. The majority [80.3%] of patients were PR3-positive and were GPA clinically. Lung involvement was common in the PR3 group; however, there was no significant difference between the two groups [viz., PR3 and MPO, P = 0.18]. ENT involvement was significantly higher in the PR3 group when compared with the MPO group [P-value=0.009]. The difference in renal involvement in both the groups was not significant [P = 0.28]. Renal biopsy findings were similar in both the PR3/MPO groups. The median follow-up period was 18 vs. 12 months in the PR3 and MPO groups, respectively. Relapse was significantly higher in the PR3 group [P = 0.017]. The PR3 group significantly required rituximab for second induction treatment [P = 0.028]. Eight patients (12.12%) died during the study period. There was no significant difference in mortality, and there was permanent organ damage in both the PR3 and MPO groups. Autoantibody-based classification is supplemental to the clinical segregation of AAV phenotypes.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Amrita Journal of Medicine

自引率

0.00%

发文量