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Spectrum and Prognosis of Antineutrophil Cytoplasmic Antibody-associated Vasculitis-related Bronchiectasis: Data from 61 Patients.
Lhote, Raphael; Chilles, Marie; Groh, Matthieu; Puéchal, Xavier; Guilpain, Philippe; Ackermann, Félix; Amoura, Zahir; Annesi-Maesano, Isabella; Barba, Thomas; Catherinot, Emilie; Cohen-Aubart, Fleur; Cohen, Pascal; Cottin, Vincent; Couderc, Louis-Jean; De Boysson, Hubert; Delbrel, Xavier; Dominique, Stéphane; Duhaut, Pierre; Fain, Olivier; Hachulla, Eric; Hamidou, Mohamed; Kahn, Jean-Emmanuel; Legendre, Christophe; Le Quellec, Alain; Lhote, François; Lifermann, François; Mathian, Alexis; Néel, Antoine; Nunes, Hilario; Subra, Jean-François; Terrier, Benjamin; Mouthon, Luc; Diot, Elisabeth; Guillevin, Loïc; Brillet, Pierre-Yves; Tcherakian, Colas.
Affiliation
  • Lhote R; R. Lhote, MD, Department of Pulmonology, Hôpital Foch, Suresnes, Faculté des Sciences de la Vie, Simone Veil, Université de Versailles, UPRES EA 220, and Sorbonne Université, University of Pierre and Marie Curie (UPMC), Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Epi
  • Chilles M; M. Chilles, MD, Department of Internal Medicine, Orléans, and Department of Internal Medicine, CHU, Tours.
  • Groh M; M. Groh, MD, F. Ackermann, MD, J.E. Kahn, MD, PhD, Department of Internal Medicine, CEREO (National Referral Center for Hypereosinophilic Syndromes), Hôpital Foch, Suresnes.
  • Puéchal X; X. Puéchal, MD, PhD, P. Cohen, MD, B. Terrier, MD, PhD, L. Mouthon, MD, PhD, L. Guillevin, MD, Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris.
  • Guilpain P; Philippe Guilpain, MD, PhD, A. Le Quellec, MD, PhD, Department of Internal Medicine, Saint Eloi Hospital, Montpellier.
  • Ackermann F; M. Groh, MD, F. Ackermann, MD, J.E. Kahn, MD, PhD, Department of Internal Medicine, CEREO (National Referral Center for Hypereosinophilic Syndromes), Hôpital Foch, Suresnes.
  • Amoura Z; Z. Amoura, MD, MSc, F. Cohen-Aubart, MD, PhD, A. Mathian, MD, PhD, Sorbonne Université, INSERM UMRS 1135, Department of Internal Medicine 2, Centre National de Référence Maladies Auto-Immunes et Systémiques Rares Lupus et Syndrome des Anticorps Antiphospholipides Centre de Référence des Histiocytose
  • Annesi-Maesano I; I. Annesi-Maesano, MD, PhD, Sorbonne Université, UPMC, Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Saint-Antoine Medical School, Paris.
  • Barba T; T. Barba, MD, V. Cottin, MD, PhD, Department of Pulmonology, Louis Pradel Hospital, Lyon.
  • Catherinot E; E. Catherinot, MD, PhD, L.J. Couderc, MD, C. Tcherakian, MD, PhD, 1Department of Pulmonology, Hôpital Foch, Suresnes, Faculté des Sciences de la Vie, Simone Veil, Université de Versailles, UPRES EA 220.
  • Cohen-Aubart F; Z. Amoura, MD, MSc, F. Cohen-Aubart, MD, PhD, A. Mathian, MD, PhD, Sorbonne Université, INSERM UMRS 1135, Department of Internal Medicine 2, Centre National de Référence Maladies Auto-Immunes et Systémiques Rares Lupus et Syndrome des Anticorps Antiphospholipides Centre de Référence des Histiocytose
  • Cohen P; X. Puéchal, MD, PhD, P. Cohen, MD, B. Terrier, MD, PhD, L. Mouthon, MD, PhD, L. Guillevin, MD, Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris.
  • Cottin V; T. Barba, MD, V. Cottin, MD, PhD, Department of Pulmonology, Louis Pradel Hospital, Lyon.
  • Couderc LJ; E. Catherinot, MD, PhD, L.J. Couderc, MD, C. Tcherakian, MD, PhD, 1Department of Pulmonology, Hôpital Foch, Suresnes, Faculté des Sciences de la Vie, Simone Veil, Université de Versailles, UPRES EA 220.
  • De Boysson H; H. De Boysson, MD, Departments of Internal Medicine, University Hospital, Caen.
  • Delbrel X; X. Delbrel, MD, Department of Internal Medicine, François Mitterand Hospital, Pau.
  • Dominique S; S. Dominique, MD, Department of Pulmonology Department, Charles Nicolle University Hospital, Rouen.
  • Duhaut P; P. Duhaut, MD, PhD, Department of Internal Medicine, University Hospital, Amiens.
  • Fain O; Olivier Fain, MD, PhD, Department of Internal Medicine, Saint Antoine Hospital, Paris.
  • Hachulla E; E. Hachulla, MD, PhD, Department of Internal Medicine, Centre de Reference des Maladies Auto-immunes Systémique Rares du Nord et du Nord-Ouest de France (CeRAINO), CHRU de Lille, Université de Lille, Lille.
  • Hamidou M; M. Hamidou, MD, PhD, A. Néel, MD, PhD, Department of Internal Medicine, CHU, Nantes.
  • Kahn JE; M. Groh, MD, F. Ackermann, MD, J.E. Kahn, MD, PhD, Department of Internal Medicine, CEREO (National Referral Center for Hypereosinophilic Syndromes), Hôpital Foch, Suresnes.
  • Legendre C; Christophe Legendre, MD, PhD, Department of Nephrology, Necker Enfants Malades Hospital, Paris.
  • Le Quellec A; Philippe Guilpain, MD, PhD, A. Le Quellec, MD, PhD, Department of Internal Medicine, Saint Eloi Hospital, Montpellier.
  • Lhote F; F. Lhote, MD, Department of Internal Medicine, Delafontaine Hospital, Saint Denis.
  • Lifermann F; F. Lifermann, MD, Department of Internal Medicine, Dax Hospital, Dax.
  • Mathian A; Z. Amoura, MD, MSc, F. Cohen-Aubart, MD, PhD, A. Mathian, MD, PhD, Sorbonne Université, INSERM UMRS 1135, Department of Internal Medicine 2, Centre National de Référence Maladies Auto-Immunes et Systémiques Rares Lupus et Syndrome des Anticorps Antiphospholipides Centre de Référence des Histiocytose
  • Néel A; M. Hamidou, MD, PhD, A. Néel, MD, PhD, Department of Internal Medicine, CHU, Nantes.
  • Nunes H; H. Nunes, MD, PhD, Department of Pulmonology, Avicenne Hospital, Bobigny.
  • Subra JF; J.F. Subra, MD, PhD, Department of Nephrology-Dialysis-Transplantation, Angers University Hospital, Angers.
  • Terrier B; X. Puéchal, MD, PhD, P. Cohen, MD, B. Terrier, MD, PhD, L. Mouthon, MD, PhD, L. Guillevin, MD, Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris.
  • Mouthon L; X. Puéchal, MD, PhD, P. Cohen, MD, B. Terrier, MD, PhD, L. Mouthon, MD, PhD, L. Guillevin, MD, Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris.
  • Diot E; E. Diot, MD, PhD, Department of Internal Medicine, CHU, Tours.
  • Guillevin L; X. Puéchal, MD, PhD, P. Cohen, MD, B. Terrier, MD, PhD, L. Mouthon, MD, PhD, L. Guillevin, MD, Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, AP-HP, Université Paris Descartes, Paris.
  • Brillet PY; P.Y. Brillet, MD, PhD, Department of Radiology, Avicenne Hospital, Bobigny, France.
J Rheumatol ; 47(10): 1522-1531, 2020 10 01.
Article in En | MEDLINE | ID: mdl-31787599
ABSTRACT

OBJECTIVE:

To report on a large series of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and bronchiectasis, with a specific focus on the timeline of occurrence of both features.

METHODS:

Retrospective nationwide multicenter study of patients diagnosed with both AAV and bronchiectasis.

RESULTS:

Sixty-one patients were included, among whom 27 (44.25%) had microscopic polyangiitis (MPA), 27 (44.25%) had granulomatosis with polyangiitis (GPA), and 7 (11.5%) had eosinophilic GPA. Thirty-nine (64%) had myeloperoxidase (MPO)-ANCA and 13 (21%) had proteinase 3-ANCA. The diagnosis of bronchiectasis either preceded (n = 25; median time between both diagnoses 16 yrs, IQR 4-54 yrs), was concomitant to (n = 12), or followed (n = 24; median time between both diagnoses 1, IQR 0-6 yrs) that of AAV. Patients in whom bronchiectasis precedes the onset of AAV (B-AAV group) have more frequent mononeuritis multiplex, MPA, MPO-ANCA, and a 5-fold increase of death. The occurrence of an AAV relapse tended to be protective against bronchiectasis worsening (HR 0.6, 95% CI 0.4-0.99, P = 0.049), while a diagnosis of bronchiectasis before AAV (HR 5.8, 95% CI 1.2-28.7, P = 0.03) or MPA (HR 18.1, 95% CI 2.2-146.3, P = 0.01) were associated with shorter survival during AAV follow-up.

CONCLUSION:

The association of bronchiectasis with AAV is likely not accidental and is mostly associated with MPO-ANCA. Patients in whom bronchiectasis precedes the onset of AAV tend to have distinct clinical and biological features and could carry a worse prognosis.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Bronchiectasis / Granulomatosis with Polyangiitis / Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: J Rheumatol Year: 2020 Document type: Article
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Bronchiectasis / Granulomatosis with Polyangiitis / Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis Type of study: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: J Rheumatol Year: 2020 Document type: Article