Pulmonary involvement in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis : The influence of ANCA subtype
(2017) In Journal of Rheumatology 44(10). p.1458-1467- Abstract
Objective. To describe pulmonary involvement at time of diagnos is in a ntineutrophil cytoplasm ic antibodies (ANCA)-associated vasculitis (AAV), as defined by computed tomography (CT). Methods. Pati ents w ith thoracic CT perfor med on or after the onset of AAV (n = 140; 7 5 women; granulomatosis with polyangiitis, n = 79; microscopic polyangiitis MPA, n = 61) followed at a tertiary referral center vasculitis clinic were studied. Radiological patterns of pulmonary involvement were evaluated from the CT studies using a predefined protocol, and compared to proteinase 3 (PR3)-ANCA and myeloperoxidase (MPO)-ANCA specificity. Results. Of the patients, 77% had an abnormal thoracic CT study. The most common abnormality was nodular disease... (More)
Objective. To describe pulmonary involvement at time of diagnos is in a ntineutrophil cytoplasm ic antibodies (ANCA)-associated vasculitis (AAV), as defined by computed tomography (CT). Methods. Pati ents w ith thoracic CT perfor med on or after the onset of AAV (n = 140; 7 5 women; granulomatosis with polyangiitis, n = 79; microscopic polyangiitis MPA, n = 61) followed at a tertiary referral center vasculitis clinic were studied. Radiological patterns of pulmonary involvement were evaluated from the CT studies using a predefined protocol, and compared to proteinase 3 (PR3)-ANCA and myeloperoxidase (MPO)-ANCA specificity. Results. Of the patients, 77% had an abnormal thoracic CT study. The most common abnormality was nodular disease (24%), of which the majority were peribronchial nodules, followed by bronchiectasis and pleural effusion (19%, each), pulmonary hemorrhage and lymph node enlargement (14%, each), emphysema (13%), and cavitating lesions (11%). Central airways disease and a n odular pattern of pulmonary involvement were more common in PR3-ANCA-positive patients (p < 0.05). Usual interstitial pneumonitis (UIP) and bronchiectasis were more prevalent in MPO-ANCA-positive patients (p < 0.05). Alveolar hemorrhage, pleural effusion, lymph node enlargement, and pulmonary venous congestion were more frequent in MPO-ANCA-positive patients. Conclusion. Pulmonary involvement is frequent and among 140 patients with AAV who underwent a thoracic CT study, almost 80% have pulmonary abnormalities on thoracic CT. Central airway disease oc curs exclusively among patients with PR3-ANCA while UIP were mainl y seen in those wit h MPO-ANCA. These findings may have important implications for the investigation, ma nagement, and pathogenesis of AAV.
(Less)
- author
- Mohammad, Aladdin J. LU ; Mortensen, Kristian H. ; Babar, Judith ; Smith, Rona ; Jones, Rachel B ; Nakagomi, Daiki ; Sivasothy, Pasupathy and Jayne, David R. W.
- organization
- publishing date
- 2017-10-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- ANCA-Associated vasculitis, Computed tomography scan, Myeloperoxidase pulmonary, Outcome, Proteinase 3
- in
- Journal of Rheumatology
- volume
- 44
- issue
- 10
- pages
- 10 pages
- publisher
- Journal of Rheumatology Publishing Company Limited
- external identifiers
-
- scopus:85030319384
- pmid:28765242
- wos:000412085100007
- ISSN
- 0315-162X
- DOI
- 10.3899/jrheum.161224
- language
- English
- LU publication?
- yes
- id
- d788a721-2ba0-4ab6-b44b-0c0fdd6dc5ad
- date added to LUP
- 2017-10-24 15:53:18
- date last changed
- 2024-05-27 01:11:56
@article{d788a721-2ba0-4ab6-b44b-0c0fdd6dc5ad,
abstract = {{<p>Objective. To describe pulmonary involvement at time of diagnos is in a ntineutrophil cytoplasm ic antibodies (ANCA)-associated vasculitis (AAV), as defined by computed tomography (CT). Methods. Pati ents w ith thoracic CT perfor med on or after the onset of AAV (n = 140; 7 5 women; granulomatosis with polyangiitis, n = 79; microscopic polyangiitis MPA, n = 61) followed at a tertiary referral center vasculitis clinic were studied. Radiological patterns of pulmonary involvement were evaluated from the CT studies using a predefined protocol, and compared to proteinase 3 (PR3)-ANCA and myeloperoxidase (MPO)-ANCA specificity. Results. Of the patients, 77% had an abnormal thoracic CT study. The most common abnormality was nodular disease (24%), of which the majority were peribronchial nodules, followed by bronchiectasis and pleural effusion (19%, each), pulmonary hemorrhage and lymph node enlargement (14%, each), emphysema (13%), and cavitating lesions (11%). Central airways disease and a n odular pattern of pulmonary involvement were more common in PR3-ANCA-positive patients (p < 0.05). Usual interstitial pneumonitis (UIP) and bronchiectasis were more prevalent in MPO-ANCA-positive patients (p < 0.05). Alveolar hemorrhage, pleural effusion, lymph node enlargement, and pulmonary venous congestion were more frequent in MPO-ANCA-positive patients. Conclusion. Pulmonary involvement is frequent and among 140 patients with AAV who underwent a thoracic CT study, almost 80% have pulmonary abnormalities on thoracic CT. Central airway disease oc curs exclusively among patients with PR3-ANCA while UIP were mainl y seen in those wit h MPO-ANCA. These findings may have important implications for the investigation, ma nagement, and pathogenesis of AAV.</p>}},
author = {{Mohammad, Aladdin J. and Mortensen, Kristian H. and Babar, Judith and Smith, Rona and Jones, Rachel B and Nakagomi, Daiki and Sivasothy, Pasupathy and Jayne, David R. W.}},
issn = {{0315-162X}},
keywords = {{ANCA-Associated vasculitis; Computed tomography scan; Myeloperoxidase pulmonary; Outcome; Proteinase 3}},
language = {{eng}},
month = {{10}},
number = {{10}},
pages = {{1458--1467}},
publisher = {{Journal of Rheumatology Publishing Company Limited}},
series = {{Journal of Rheumatology}},
title = {{Pulmonary involvement in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis : The influence of ANCA subtype}},
url = {{http://dx.doi.org/10.3899/jrheum.161224}},
doi = {{10.3899/jrheum.161224}},
volume = {{44}},
year = {{2017}},
}