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Chest and renal involvements, Birmingham vascular activity score more than 13.5 and five factor score (1996) more than 1 at diagnosis are significant predictors of relapse of microscopic polyangiitis

 Y. Oh  ;  S. Ahn  ;  E. Park  ;  S. Jung  ;  J. Song  ;  Y. Park  ;  S. Lee 
 Clinical and Experimental Rheumatology, Vol.35(Suppl. 103) : 47-54, 2017 
Journal Title
 Clinical and Experimental Rheumatology 
Issue Date
Aged ; Antibodies, Antineutrophil Cytoplasmic/blood ; Biomarkers/blood ; Decision Support Techniques* ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Kidney Diseases/blood ; Kidney Diseases/diagnosis* ; Kidney Diseases/etiology ; Kidney Diseases/therapy ; Logistic Models ; Lung Diseases/blood ; Lung Diseases/diagnosis* ; Lung Diseases/etiology ; Lung Diseases/therapy ; Male ; Medical Records ; Microscopic Polyangiitis/blood ; Microscopic Polyangiitis/complications ; Microscopic Polyangiitis/diagnosis* ; Microscopic Polyangiitis/therapy ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Recurrence ; Remission Induction ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome
OBJECTIVES: We investigated whether specified organ involvements, antineutrophil cytoplasmic antibody (ANCA) positivity, Birmingham vasculitis activity score (BVAS) and five factor scores (FFS) at diagnosis could predict relapse of microscopic polyangiitis (MPA). METHODS: We reviewed the medical records of 90 patients with MPA. We collected clinical and prognostic data, (MPO)-ANCA and proteinase 3 (PR3)-ANCA, BVAS and FFS at diagnosis, and we compared them between the two groups. The optimal cut-off values of BVAS and FFS (1996) for predicting relapse were extrapolated. RESULTS: The mean age of patients (63 women) was 62.3 years and the mean follow-up duration was 41.7 months. At diagnosis, the mean BVAS, FFS (1996) and FFS (2009) of patients in no remission group were higher than those of patients in remission group (p<0.005 for all). Patients in relapse group exhibited chest and renal manifestations more frequently than those in no relapse group and the mean BVAS and FFS (1996) of patients in relapse group were significantly higher than those of patients in remission group (p<0.005 for all). There were no differences in MPO-ANCA and PR3-ANCA between the two groups. On multivariate logistic regression analysis, chest and renal manifestations were all independent predictors of relapse (OR 2.013 and OR 3.517). Patients who had BVAS ≥13.5 and FFS ≥ 1 exhibited a significantly increased risk of relapse than those who did not (RR 4.408 and RR 3.030). CONCLUSIONS: Chest and renal involvements, BVAS ≥13.5 and FFS ≥1 at diagnosis were independent predictors of relapse of MPA.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박용범(Park, Yong Beom)
박은성(Park, Eun Seong )
송정식(Song, Jungsik Jason) ORCID logo https://orcid.org/0000-0003-0662-7704
안성수(Ahn, Sung Soo) ORCID logo https://orcid.org/0000-0002-9002-9880
이상원(Lee, Sang Won) ORCID logo https://orcid.org/0000-0002-8038-3341
정승민(Jung, Seung Min ) ORCID logo https://orcid.org/0000-0003-3465-2181
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