ABSTRACT
Long-term observation of patients with ANCA-associated vasculitis (AAV) allows the identification of different longitudinal patterns of ANCA levels during follow-up. This study aimed to characterize these patterns and to determine their prognostic significance. All ANCA determinations performed in two university hospitals during a 2-year period were retrospectively reviewed. Patients were included in the analysis if they had high titers of anti-myeloperoxidase (anti-MPO) or anti-proteinase 3 (anti-PR3) antibodies at least once, ≥ 5 serial ANCA determinations and AAV diagnosed by biopsy or American College of Rheumatology (ACR) classification criteria. Patients' time-course ANCA patterns were classified as monophasic, remitting, recurrent or persistent. Associations between ANCA patterns and prognostic variables (relapse rate and renal outcome) were analysed by univariate and multivariate statistics. A total of 99 patients [55 with microscopic polyangiitis (MPA), 36 with granulomatosis with polyangiitis (GPA) and eight with eosinophilic granulomatosis with polyangiitis (EGPA)] were included. Median follow-up was 9 years. Among patients diagnosed with MPA or GPA, recurrent or persistent ANCA patterns were associated with a higher risk of clinical relapse [hazard ratio (HR) = 3·7, 95% confidence interval (CI) = 1·5-9·1 and HR = 2·9, 95% CI = 1·1-8·0, respectively], independently of clinical diagnosis or ANCA specificity. In patients with anti-MPO antibodies, the recurrent ANCA pattern was associated with worsening renal function [odds ratio (OR) = 5·7, 95% CI = 1·2-26·0]. Recurrent or persistent ANCA patterns are associated with a higher risk of clinical relapse. A recurrent ANCA pattern was associated with worsening renal function in anti-MPO-associated vasculitis.
Subject(s)
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/pathology , Antibodies, Antineutrophil Cytoplasmic/metabolism , Kidney/pathology , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/metabolism , Biopsy , Chronic Disease , Churg-Strauss Syndrome/metabolism , Churg-Strauss Syndrome/pathology , Female , Follow-Up Studies , Granulomatosis with Polyangiitis/pathology , Humans , Kidney/metabolism , Male , Microscopic Polyangiitis/metabolism , Microscopic Polyangiitis/pathology , Middle Aged , Myeloblastin/metabolism , Peroxidase/metabolism , Prognosis , Recurrence , Retrospective StudiesSubject(s)
Antipruritics/administration & dosage , Aprepitant/administration & dosage , Lymphoma, T-Cell, Cutaneous/complications , Pruritus/drug therapy , Skin Neoplasms/complications , Dose-Response Relationship, Drug , Drug Administration Schedule , Humans , Pruritus/complications , Retrospective Studies , Treatment OutcomeSubject(s)
Mycosis Fungoides/mortality , Severity of Illness Index , Skin Neoplasms/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Disease Progression , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Mycosis Fungoides/diagnosis , Prognosis , Risk Assessment/methods , Skin Neoplasms/diagnosis , Spain/epidemiology , Young AdultSubject(s)
Accidents, Occupational , Burns, Chemical/etiology , Dermatitis, Allergic Contact/etiology , Preservatives, Pharmaceutical/adverse effects , Thiazoles/adverse effects , Adrenal Cortex Hormones/therapeutic use , Adult , Betamethasone Valerate/administration & dosage , Burns, Chemical/immunology , Dermatitis, Allergic Contact/drug therapy , Dose-Response Relationship, Drug , Facial Dermatoses/drug therapy , Facial Dermatoses/etiology , Female , Foot Dermatoses/drug therapy , Foot Dermatoses/etiology , Hand Dermatoses/drug therapy , Hand Dermatoses/etiology , HumansABSTRACT
No disponible
No disponible
Subject(s)
Humans , Female , Middle Aged , Granulomatosis, Orofacial/diagnosis , Lupus Erythematosus, Systemic/diagnosis , Prednisone/therapeutic useSubject(s)
Lupus Erythematosus, Cutaneous/complications , Vitiligo/complications , Adult , Female , HumansABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Lupus Erythematosus, Cutaneous/diagnosis , Lupus Erythematosus, Cutaneous/immunology , Lupus Erythematosus, Cutaneous/pathology , Vitiligo/diagnosis , Vitiligo/immunology , Vitiligo/pathology , Biopsy/instrumentation , Biopsy/methods , Biopsy , Hypopigmentation/complications , Hypopigmentation/diagnosis , Hypopigmentation/immunologyABSTRACT
El liquen escleroso es una enfermedad inflamatoria crónica mucocutánea que causa una gran molestia en hombres y mujeres de todas las edades. La etiología exacta es desconocida, aunque factores genéticos, autoinmunitarios e infecciosos se han implicado en su patogénesis. El tratamiento de primera línea es la corticoterapia ultrapotente tópica durante un tiempo limitado, y se reserva la cirugía en caso de fimosis, estenosis uretral, sinequias y carcinoma escamoso (AU)
Lichen sclerosus is a chronic inflammatory mucocutaneous disease that is highly bothersome for men and women of all ages. The exact etiology is unknown, although genetic and autoimmune factors, as well as infections, have been implicated in its pathogenesis. First-line treatment is highly potent topical corticosteroid therapy for short periods. Surgery is reserved for cases of phimosis, urethral stenosis, synechiae, and squamous cell carcinoma (AU)
Subject(s)
Humans , Female , Child , Lichen Sclerosus et Atrophicus/diagnosis , Lichen Sclerosus et Atrophicus/drug therapy , Lichen Sclerosus et Atrophicus/complications , Autoimmune Diseases/epidemiology , Adrenal Cortex Hormones/therapeutic use , Clobetasol/therapeutic use , Lichen Sclerosus et Atrophicus/epidemiology , Retrospective Studies , Autoimmunity , Diagnosis, DifferentialABSTRACT
Lichen sclerosus is a chronic inflammatory mucocutaneous disease that is highly bothersome for men and women of all ages. The exact etiology is unknown, although genetic and autoimmune factors, as well as infections, have been implicated in its pathogenesis. First-line treatment is highly potent topical corticosteroid therapy for short periods. Surgery is reserved for cases of phimosis, urethral stenosis, synechiae, and squamous cell carcinoma.
Subject(s)
Lichen Sclerosus et Atrophicus , Adrenal Cortex Hormones/therapeutic use , Adult , Algorithms , Anti-Inflammatory Agents/therapeutic use , Autoimmune Diseases/immunology , Child , Diagnosis, Differential , Female , Genetic Predisposition to Disease , Genital Diseases, Female/diagnosis , Genital Diseases, Female/pathology , Genital Diseases, Male/diagnosis , Genital Diseases, Male/pathology , Gonadal Steroid Hormones/physiology , Humans , Lichen Sclerosus et Atrophicus/diagnosis , Lichen Sclerosus et Atrophicus/drug therapy , Lichen Sclerosus et Atrophicus/etiology , Lichen Sclerosus et Atrophicus/pathology , Lichen Sclerosus et Atrophicus/physiopathology , Lichen Sclerosus et Atrophicus/surgery , MaleSubject(s)
Vulvitis/pathology , Female , Humans , Pruritus/etiology , Time Factors , Vulvitis/complications , Young AdultABSTRACT
No disponible
No disponible
Subject(s)
Humans , Female , Adult , Vulvitis/diagnosis , Pruritus Vulvae/etiology , Granuloma, Plasma Cell/diagnosis , Candidiasis, Vulvovaginal/drug therapy , Fluconazole/therapeutic use , Mucositis/diagnosisABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Adult , Leiomyomatosis/pathology , Penile Neoplasms/pathology , Prostatic Hyperplasia/complications , Diagnosis, DifferentialABSTRACT
No disponible
No disponible
