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Red Blood Cell Distribution Width Can Predict Vasculitis Activity and Poor Prognosis in Granulomatosis with Polyangiitis

 Ho Jae Kim  ;  Juyoung Yoo  ;  Seung Min Jung  ;  Jason Jungsik Song  ;  Yong Beom Park  ;  Sang Won Lee 
 Yonsei Medical Journal, Vol.59(2) : 294-302, 2018 
Journal Title
 Yonsei Medical Journal 
Issue Date
Aged ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*blood/diagnosis ; *Erythrocyte Indices ; Female ; Follow-Up Studies ; Granulomatosis with Polyangiitis/*blood/diagnosis ; Humans ; Linear Models ; Middle Aged ; Multivariate Analysis ; Prognosis
ANCA-associated vasculitis ; Red blood cell distribution width ; granulomatosis with polyangiitis ; prognosis ; vasculitis activity score
PURPOSE: We investigated whether red blood cell distribution width (RDW) predicts vasculitis activity based on Birmingham vasculitis activity score (BVAS) or BVAS for granulomatosis with polyangiitis (GPA) at diagnosis and poor prognosis during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). MATERIALS AND METHODS: We reviewed the medical records of 150 patients with AAV. We defined severe GPA as BVAS for GPA >/=7 (the highest quartile). Correlation and standardised correlation coefficients were analysed by linear regression tests. The differences between groups were evaluated by Mann-Whitney test. Relative risk (RR) was assessed by chi square test and Cox hazards model. RESULTS: RDW was correlated only with the vasculitis activity of GPA among patients with AAV. An increase in RDW was associated with the absence of ear nose throat (ENT) manifestation, but not proteinase 3-ANCA. Significant differences were noted in cumulative refractory free survival according to RDW >/=15.4% (p=0.007) and the absence of ENT manifestation (p=0.036). Multivariate Cox hazards analysis identified RDW >/=15.4% as the only significant predictor of refractory disease in GPA (RR 17.573). CONCLUSION: RDW predicts vasculitis activity in GPA, and RDW >/=15.4% at diagnosis may increase the risk of severe GPA at diagnosis and predict refractory diseases during follow-up.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
박용범(Park, Yong Beom)
송정식(Song, Jungsik Jason) ORCID logo https://orcid.org/0000-0003-0662-7704
유주영(Yoo, Juyoung) ORCID logo https://orcid.org/0000-0001-8882-1695
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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