Lung involvement at presentation predicts disease activity and permanent organ damage at 6, 12 and 24 months follow - up in ANCA - associated vasculitis

Hdl Handle:
http://hdl.handle.net/10147/322305
Title:
Lung involvement at presentation predicts disease activity and permanent organ damage at 6, 12 and 24 months follow - up in ANCA - associated vasculitis
Authors:
Hassan, Tidi M; Hassan, Astrid S; Igoe, Ann; Logan, Mark; Gunaratnam, Cedric; McElvaney, Noel G; O’Neill, Shane J
Affiliation:
Department of Respiratory, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
Citation:
BMC Immunology. 2014 May 27;15(1):20
Issue Date:
27-May-2014
URI:
http://dx.doi.org/10.1186/1471-2172-15-20; http://hdl.handle.net/10147/322305
Abstract:
Abstract Background Antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis (AAV) may present with pulmonary involvement ranging from mild to life-threatening disease such as diffuse alveolar hemorrhage. There is a paucity of information regarding morbidity outcomes for AAV subjects presenting with lung involvement. This study determines the relationship between disease activity and damage in these subjects using the Birmingham Vasculitis Activity Score v 3 (BVAS 3) and Vasculitis Damage Index (VDI) respectively. Results 151 patients with AAV were included with 59 presenting initially with pulmonary involvement. The initial BVAS scores recorded at time of diagnosis were positively correlated with the final VDI scores at 24 months (p < 0.0001, rs = 0.5871). No differences between BVAS and VDI scores were seen for both groups, however in the lung-involvement group only, BVAS scores were significantly higher at 6, 12 and 24 months whilst the VDI scores were significantly higher at 12 and 24 months. Subjects presenting with pulmonary involvement had an increased likelihood for cardiovascular (OR 1.31, 95% CI 0.89, 1.54; p = 0.032) and renal (OR 1.32, 95% CI 1.22, 1.39; p = 0.005) involvement. Subjects presenting with lung involvement with granulomatosis with polyangiitis and microscopic polyangiitis had 24-month VDI scores that were significantly higher (p = 0.027, p = 0.045), and more likely to develop pulmonary fibrosis (OR 1.79, 95% CI 1.48, 2.12; p < 0.001). Conclusion AAV subjects with lung involvement at presentation had a higher disease activity and damage scores at 6, 12 and 24 months follow-up representing a considerable burden of disease despite improvement in overall survival due to the introduction of immunosuppressive therapy.
Item Type:
Article
Language:
en
Local subject classification:
IMMUNOLOGY; ORGAN DAMAGE

Full metadata record

DC FieldValue Language
dc.contributor.authorHassan, Tidi Men_GB
dc.contributor.authorHassan, Astrid Sen_GB
dc.contributor.authorIgoe, Annen_GB
dc.contributor.authorLogan, Marken_GB
dc.contributor.authorGunaratnam, Cedricen_GB
dc.contributor.authorMcElvaney, Noel Gen_GB
dc.contributor.authorO’Neill, Shane Jen_GB
dc.date.accessioned2014-06-30T09:15:55Z-
dc.date.available2014-06-30T09:15:55Z-
dc.date.issued2014-05-27-
dc.identifier.citationBMC Immunology. 2014 May 27;15(1):20en_GB
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2172-15-20-
dc.identifier.urihttp://hdl.handle.net/10147/322305-
dc.description.abstractAbstract Background Antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis (AAV) may present with pulmonary involvement ranging from mild to life-threatening disease such as diffuse alveolar hemorrhage. There is a paucity of information regarding morbidity outcomes for AAV subjects presenting with lung involvement. This study determines the relationship between disease activity and damage in these subjects using the Birmingham Vasculitis Activity Score v 3 (BVAS 3) and Vasculitis Damage Index (VDI) respectively. Results 151 patients with AAV were included with 59 presenting initially with pulmonary involvement. The initial BVAS scores recorded at time of diagnosis were positively correlated with the final VDI scores at 24 months (p < 0.0001, rs = 0.5871). No differences between BVAS and VDI scores were seen for both groups, however in the lung-involvement group only, BVAS scores were significantly higher at 6, 12 and 24 months whilst the VDI scores were significantly higher at 12 and 24 months. Subjects presenting with pulmonary involvement had an increased likelihood for cardiovascular (OR 1.31, 95% CI 0.89, 1.54; p = 0.032) and renal (OR 1.32, 95% CI 1.22, 1.39; p = 0.005) involvement. Subjects presenting with lung involvement with granulomatosis with polyangiitis and microscopic polyangiitis had 24-month VDI scores that were significantly higher (p = 0.027, p = 0.045), and more likely to develop pulmonary fibrosis (OR 1.79, 95% CI 1.48, 2.12; p < 0.001). Conclusion AAV subjects with lung involvement at presentation had a higher disease activity and damage scores at 6, 12 and 24 months follow-up representing a considerable burden of disease despite improvement in overall survival due to the introduction of immunosuppressive therapy.-
dc.language.isoenen
dc.subject.otherIMMUNOLOGYen_GB
dc.subject.otherORGAN DAMAGEen_GB
dc.titleLung involvement at presentation predicts disease activity and permanent organ damage at 6, 12 and 24 months follow - up in ANCA - associated vasculitisen_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Respiratory, Beaumont Hospital, Beaumont Road, Dublin 9, Irelanden_GB
dc.language.rfc3066en-
dc.rights.holderTidi M Hassan et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2014-06-20T23:04:00Z-
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