Clinical associations of renal involvement in ANCA-associated vasculitis.

Abstract:

OBJECTIVE:Renal involvement in anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis is associated with significant morbidity and higher mortality rates. This study examined clinical manifestations associated with renal involvement in ANCA-associated vasculitis within a large, international cross-sectional cohort. METHODS:Univariate and multivariate analyses were performed to identify clinical factors associated with renal disease, which was defined as i) a serum-creatinine >30% above normal and a fall in creatinine-clearance >25%; or ii) haematuria attributable to active vasculitis. RESULTS:The study cohort include 1230 patients from 31 countries; 723 (58.8%) presented with renal involvement: microscopic polyangiitis (82.2%), granulomatosis with polyangiitis (58.6%), and eosinophilic granulomatosis with polyangiitis (26.4%). The following clinical and laboratory factors were more common among patients with renal disease: age (OR 1.01, 95% CI 1.01-1.02), fever (OR 1.97, 95% CI 1.35-2.88), fatigue (OR 1.55, 95% CI 1.14-2.10), weight loss (OR 1.62, 95% CI 1.23-2.12), polyarthritis (OR 1.39, 95% CI 1.02-1.89), petechiae/purpura (OR 1.47, 95% CI 1.06-2.05), pulmonary haemorrhage (OR 5.23, 95% CI 1.39-19.63), gastrointestinal symptoms (OR 2.19, 95% CI 1.34-3.58), seizures (OR 3.42, 95% CI 1.26-9.30), lower serum albumin (OR 2.42, 95% CI 1.64-3.57), higher CRP (OR 2.06, 95% CI 1.04-4.06), low serum C3 at baseline (OR 3.86, 95% CI 1.30-11.53), myeloperoxidase- (OR 7.97, 95% CI 2.74-23.20) and proteinase 3-ANCA (OR 3.40, 95% CI 1.22-9.50). The following clinical factors were less common among patients with renal disease: mononeuritis multiplex (OR 0.63, 95% CI 0.41-0.98), proptosis/exophthalmos (OR 0.19, 95% CI 0.06-0.59), nasal polyps (OR 0.32, 95% CI 0.19-0.55), septal defect/perforation (OR 0.29, 95% CI 0.14-0.60), respiratory distress/pulmonary fibrosis/asthma (OR 0.08, 95% CI 0.04-0.19), and wheeze/obstructive airway disease (OR 0.29, 95% CI 0.16-0.52). CONCLUSION:In this large international study, several clinical and laboratory factors were identified as associated with renal involvement in ANCA-associated vasculitis.

journal_name

Autoimmun Rev

journal_title

Autoimmunity reviews

authors

Kronbichler A,Shin JI,Lee KH,Nakagomi D,Quintana LF,Busch M,Craven A,Luqmani RA,Merkel PA,Mayer G,Jayne DRW,Watts RA

doi

10.1016/j.autrev.2020.102495

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

102495

issue

4

eissn

1568-9972

issn

1873-0183

pii

S1568-9972(20)30043-4

journal_volume

19

pub_type

杂志文章,评审
  • Therapy of scleroderma renal crisis: State of the art.

    abstract::Scleroderma renal crisis (SRC) is an uncommon but still life-threatening manifestation of systemic sclerosis (SSc). The incidence of SRC has decreased in the last few decades, probably due to a widespread use of vasodilators in SSc patients. It is well-recognized that exposure to different drugs can trigger SRC (corti...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2018.03.012

    authors: Zanatta E,Polito P,Favaro M,Larosa M,Marson P,Cozzi F,Doria A

    更新日期:2018-09-01 00:00:00

  • Idiopathic inflammatory myopathies and the anti-synthetase syndrome: a comprehensive review.

    abstract::Autoantibodies are a hallmark in the diagnosis of many systemic autoimmune rheumatic diseases (SARD) including idiopathic inflammatory myopathies (IIM). Based on their specificity, autoantibodies in IIM are grouped into myositis specific (MSA) and myositis associated autoantibodies (MAA). Among the MSA, autoantibodies...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2014.01.022

    authors: Mahler M,Miller FW,Fritzler MJ

    更新日期:2014-04-01 00:00:00

  • Autoantibody pain.

    abstract::As autoantibodies bind to target tissues, Fc-region dependent inflammation can induce pain via mediators exciting nociceptors. But recently another possibility has emerged, where autoantibody binding to nociceptors can directly cause pain, without inflammation. This is thought to occur as a result of Fab-region mediat...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2016.02.011

    authors: Goebel A

    更新日期:2016-06-01 00:00:00

  • Complex regional pain syndrome - False hopes and miscommunications.

    abstract::Complex regional pain syndrome (CRPS) has been considered to be an autoimmune disease and there have been clinical trials with intravenous immunoglobulin. Often the etiology of the so-called CRPS diagnosis cannot be discerned and there are no validated instruments that provide functional metrics. The term complex regi...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2018.10.003

    authors: Chang C,McDonnell P,Gershwin ME

    更新日期:2019-03-01 00:00:00

  • Pathophysiology of myasthenia gravis with antibodies to the acetylcholine receptor, muscle-specific kinase and low-density lipoprotein receptor-related protein 4.

    abstract::Myasthenia gravis is caused by antibodies to the acetylcholine receptor, muscle-specific kinase, low-density lipoprotein receptor-related protein 4, or possibly yet unidentified antibodies. The mechanisms by which these antibodies interfere with the function of postsynaptic proteins include complement activation, anti...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2013.03.001

    authors: Verschuuren JJ,Huijbers MG,Plomp JJ,Niks EH,Molenaar PC,Martinez-Martinez P,Gomez AM,De Baets MH,Losen M

    更新日期:2013-07-01 00:00:00

  • Infectome: a platform to trace infectious triggers of autoimmunity.

    abstract::The "exposome" is a term recently used to describe all environmental factors, both exogenous and endogenous, which we are exposed to in a lifetime. It represents an important tool in the study of autoimmunity, complementing classical immunological research tools and cutting-edge genome wide association studies (GWAS)....

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2012.12.005

    authors: Bogdanos DP,Smyk DS,Invernizzi P,Rigopoulou EI,Blank M,Pouria S,Shoenfeld Y

    更新日期:2013-05-01 00:00:00

  • Mechanistic immunological based classification of rheumatoid arthritis.

    abstract::The classical autoimmunity paradigm in rheumatoid arthritis (RA) is strongly supported by immunogenetics suggesting follicular helper T-cell responses driving high titre specific autoantibodies that pre-dates disease onset. Using the immunological disease continuum model of inflammation against self with "pure" adapti...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2018.06.001

    authors: McGonagle D,Watad A,Savic S

    更新日期:2018-11-01 00:00:00

  • Anti-TNFalpha therapy in a cohort of rheumatoid arthritis patients: clinical outcomes.

    abstract:OBJECTIVE:To assess the effectiveness of anti-TNFalpha agents by analysing the principal clinical outcomes in patients with active rheumatoid arthritis (RA). METHODS:1010 patients who received no clinical benefit from previous treatment with methotrexate and/or other DMARDs, were subsequently treated with one or more ...

    journal_title:Autoimmunity reviews

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.autrev.2008.11.001

    authors: Bazzani C,Filippini M,Caporali R,Bobbio-Pallavicini F,Favalli EG,Marchesoni A,Atzeni F,Sarzi-Puttini P,Gorla R

    更新日期:2009-01-01 00:00:00

  • Tools for critical appraisal of evidence in studies of diagnostic accuracy.

    abstract::Studies of accuracy are often more complex to understand than clinical trials, since there can be more than one outcome and scope (screening, diagnosis, and prognosis) and because results have to be reported in more than one way, than in clinical trials (relative risk or odds ratio). Sensitivity and specificity are co...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1016/j.autrev.2012.07.004

    authors: Giavarina D

    更新日期:2012-12-01 00:00:00

  • The etiology of autoimmune diabetes and thyroiditis: evidence for common genetic susceptibility.

    abstract::Type 1 diabetes (T1D) and the autoimmune thyroid diseases (AITD) are the most common autoimmune endocrine diseases. Both are organ-specific T-cell mediated diseases. Abundant epidemiological data support a strong genetic basis for both T1D and AITD. Furthermore, both diseases commonly occur in the same individuals and...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/s1568-9972(03)00080-6

    authors: Levin L,Tomer Y

    更新日期:2003-10-01 00:00:00

  • New use for an old treatment: Hydroxychloroquine as a potential treatment for systemic vasculitis.

    abstract::Antimalarials have been an effective and safe treatment for autoimmune rheumatic diseases such as systemic lupus erythematosus for more than a hundred years. There are surprisingly few reports of hydroxychloroquine use in the systemic vasculitides. Hydroxychloroquine has antithrombotic, cardiovascular, antimicrobial a...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2018.01.016

    authors: Casian A,Sangle SR,D'Cruz DP

    更新日期:2018-07-01 00:00:00

  • Rituximab for the treatment of eosinophilic granulomatosis with polyangiitis: A systematic literature review.

    abstract:OBJECTIVE:We investigated the effectiveness of rituximab (an anti-CD20 monoclonal antibody) in patients with eosinophilic granulomatosis with polyangiitis (EGPA). METHODS:We performed a systematic literature review from the inception dates until July 20, 2020 for articles reporting rituximab administration to treat EG...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2020.102737

    authors: Akiyama M,Kaneko Y,Takeuchi T

    更新日期:2021-02-01 00:00:00

  • Tight control applied to the biological therapy of rheumatoid arthritis.

    abstract::In the last decade, treatment strategies for rheumatoid arthritis (RA) have included the early use of disease-modifying anti-rheumatic drugs, since prompt suppression of disease activity is associated with a reduction in radiological damage. This strategy has now been incorporated into the broader concept of "tight co...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2012.11.010

    authors: Epis OM,Giacomelli L,Deidda S,Bruschi E

    更新日期:2013-06-01 00:00:00

  • A comprehensive analysis of treatment outcomes in patients with pemphigus vulgaris treated with rituximab.

    abstract::Approximately 500 treatment recalcitrant pemphigus vulgaris patients have been treated with rituximab. They were treated according to the lymphoma protocol (N=224) or rheumatoid arthritis protocol (RAP) (N=209) patients. Others were treated with modifications or combinations of the two. The mean duration of follow-up ...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2014.12.002

    authors: Ahmed AR,Shetty S

    更新日期:2015-04-01 00:00:00

  • Complement associated pathogenic mechanisms in myasthenia gravis.

    abstract::The complement system is profoundly involved in the pathogenesis of acetylcholine receptor (AChR) antibody (Ab) related myasthenia gravis (MG) and its animal model experimental autoimmune myasthenia gravis (EAMG). The most characteristic finding of muscle pathology in both MG and EAMG is the abundance of IgG and compl...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2013.03.003

    authors: Tüzün E,Christadoss P

    更新日期:2013-07-01 00:00:00

  • Novel risk factors related to cancer in scleroderma.

    abstract:OBJECTIVE:Emerging data have shown an increased risk of malignancy among patients diagnosed with systemic sclerosis (SSc) so identification of risk factors linking both disorders might have prognostic implications. The aim of this study was to assess the clinical and treatment-related risk factors for cancer in a singl...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2017.03.012

    authors: Bernal-Bello D,de Tena JG,Guillén-Del Castillo A,Selva-O'Callaghan A,Callejas-Moraga EL,Marín-Sánchez AM,Fonollosa-Pla V,Simeón-Aznar CP

    更新日期:2017-05-01 00:00:00

  • Rhupus: a systematic literature review.

    abstract::"Rhupus" or "rhupus syndrome" is a poorly described and underdiagnosed disease in which features of both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) appear in the same patient, most often sequentially. The SLE-related involvement is usually mild, dominated by hematological abnormalities and skin, ...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章

    doi:10.1016/j.autrev.2020.102612

    authors: Antonini L,Le Mauff B,Marcelli C,Aouba A,de Boysson H

    更新日期:2020-09-01 00:00:00

  • Use of rituximab in patients with systemic lupus erythematosus: an update.

    abstract::Systemic lupus erythematosus (SLE) is a chronic, occasionally life threatening, multisystem disorder. Patients suffer from a wide group of symptoms and have a variable prognosis that depends of the severity and type of organ involvement. The clinical manifestations include fever, skin lesions, arthritis, neurologic, r...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2008.11.006

    authors: García-Carrasco M,Jiménez-Hernández M,Escárcega RO,Mendoza-Pinto C,Galarza-Maldonado C,Sandoval-Cruz M,Zamudio-Huerta L,López-Colombo A,Cervera R

    更新日期:2009-02-01 00:00:00

  • Surviving the butterfly and the wolf: mortality trends in systemic lupus erythematosus.

    abstract:OBJECTIVE:To address changes in survival of patients with systemic lupus erythematosus (SLE) and to compare mortality statistics with associated disease specific as well as comorbid conditions. METHODS:Review of the international literature on survival of patients with SLE. RESULTS:During the first half of the 20th c...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2004.04.002

    authors: Borchers AT,Keen CL,Shoenfeld Y,Gershwin ME

    更新日期:2004-08-01 00:00:00

  • B-cells and mixed cryoglobulinemia.

    abstract::Mixed cryoglobulinemia (MC) is a systemic small-vessel vasculitis; B-cell expansion is the biological substrate of the disease. It can be regarded as benign lymphoproliferative condition that may evolve to frank lymphoma. HCV infection is the main causative factor of MC, as well as of other overlapping disorders, thro...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2007.02.019

    authors: Ferri C,Antonelli A,Mascia MT,Sebastiani M,Fallahi P,Ferrari D,Giunti M,Pileri SA,Zignego AL

    更新日期:2007-12-01 00:00:00

  • Pathogenesis of ANCA-associated vasculitis: An update.

    abstract::Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) constitutes a group of rare diseases characterized by necrotizing inflammation of small blood vessels and the presence of ANCA. Although these autoantibodies were initially used to classify pauci-immune vasculitis, increasing clinical and experimen...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2016.03.007

    authors: Jarrot PA,Kaplanski G

    更新日期:2016-07-01 00:00:00

  • COVID-19 gone bad: A new character in the spectrum of the hyperferritinemic syndrome?

    abstract::The severe form of COVID-19 share several clinical and laboratory features with four entities gathered under the term "hyperferritinemic syndromes" and including macrophage activation syndrome (MAS), adult-onset Still's disease (AOSD), catastrophic anti-phospholipid syndrome (CAPS) and septic shock. COVID-19 systemic ...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2020.102573

    authors: Colafrancesco S,Alessandri C,Conti F,Priori R

    更新日期:2020-07-01 00:00:00

  • The role of innate immune responses in autoimmune disease development.

    abstract::Autoimmune diseases are systemic or organ-specific disorders that are the result of an attack of the immune system against the body's own tissue. Development of autoimmune disease is generally avoided by distinct mechanisms that silence adaptive self-reactive T or B cells. The innate immune system is critically involv...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2008.12.019

    authors: Waldner H

    更新日期:2009-03-01 00:00:00

  • Dysfunctional B cells in systemic lupus erythematosus.

    abstract::The classical view of B cells in the biology of autoimmune responses to infectious and self-antigens (Ag) that they promote immunity primarily by producing antibodies (Ab) is far from being complete. Indeed, studies over the last decade suggest that B cells have extraordinarily diverse functions within the immune syst...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2004.07.035

    authors: Renaudineau Y,Pers JO,Bendaoud B,Jamin C,Youinou P

    更新日期:2004-11-01 00:00:00

  • Rituximab treatment for IgA vasculitis: A systematic review.

    abstract:BACKGROUND:Immunoglobulin A vasculitis (IgAV) is a systemic small vessel vasculitis for which treatment of severe cases is usually based on glucocorticoids and other conventional immunosuppressive drugs. The role of rituximab for resistant or refractory cases has been explored in isolated case reports and small series....

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章

    doi:10.1016/j.autrev.2020.102490

    authors: Hernández-Rodríguez J,Carbonell C,Mirón-Canelo JA,Diez-Ruiz S,Marcos M,Chamorro AJ

    更新日期:2020-04-01 00:00:00

  • Rituximab therapy for primary central nervous system vasculitis: A 6 patient experience and review of the literature.

    abstract:OBJECTIVES:To assess the efficacy and safety of Rituximab (RTX) in adult primary central nervous system vasculitis (PCNSV). METHODS:We retrospectively assessed the effect of RTX in 6 patients with PCNSV. Five of the 6 were refractory to high dose glucocorticoids (GCs) and/or conventional immunosuppressants (IS). The s...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2018.12.002

    authors: Salvarani C,Brown RD Jr,Muratore F,Christianson TJH,Galli E,Pipitone N,Cassone G,Huston J III,Giannini C,Warrington K,Hunder GG

    更新日期:2019-04-01 00:00:00

  • Is primary biliary cirrhosis a model autoimmune disease?

    abstract::Primary biliary cirrhosis (PBC) has been coined a model autoimmune disease. In fact, it does share many similarities with other autoimmune diseases, but there are striking differences that illustrate the uniqueness of the immunopathology. Firstly, similar to other autoimmune diseases, there is an intense humoral and c...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2004.04.001

    authors: Ichiki Y,Shimoda S,Ishibashi H,Gershwin ME

    更新日期:2004-06-01 00:00:00

  • Idiopathic aplastic anemia: diagnosis and classification.

    abstract::Aplastic anemia (AA) is a disease characterized by pancytopenia and hypoplastic bone marrow caused by the decrease of hematopoietic stem cells. The pathogenesis of AA is complex and involves an abnormal hematopoietic microenvironment, hematopoietic stem cell/progenitor cell deficiencies and immunity disorders. Surviva...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2014.01.014

    authors: Dolberg OJ,Levy Y

    更新日期:2014-04-01 00:00:00

  • The role of gender and organ specific autoimmunity.

    abstract::Autoimmunity is influenced by multiple factors including gender and sex hormones. A definite female predominance is found in many autoimmune diseases. Gender is also associated with differences in clinical presentation, onset, progression and outcome of autoimmune diseases. Sex hormones might influence the target orga...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2011.11.001

    authors: Nussinovitch U,Shoenfeld Y

    更新日期:2012-05-01 00:00:00

  • Neutrophils: Novel key players in Rheumatoid Arthritis. Current and future therapeutic targets.

    abstract::Rheumatoid Arthritis (RA) is a complex systemic autoimmune disease in which various cell types are involved. Among them, neutrophils have been recognized as important players in the onset and the progression of RA. The pathogenic role of neutrophils in RA lies in the alteration of several processes, including increase...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审

    doi:10.1016/j.autrev.2018.06.006

    authors: Cecchi I,Arias de la Rosa I,Menegatti E,Roccatello D,Collantes-Estevez E,Lopez-Pedrera C,Barbarroja N

    更新日期:2018-11-01 00:00:00