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Delta Neutrophil Index Is Associated with Vasculitis Activity and Risk of Relapse in ANCA-Associated Vasculitis

 Juyoung Yoo  ;  Sung Soo Ahn  ;  Seung Min Jung  ;  Jason Jungsik Song  ;  Yong Beom Park  ;  Sang Won Lee 
 Yonsei Medical Journal, Vol.59(3) : 397-405, 2018 
Journal Title
 Yonsei Medical Journal 
Issue Date
Adult ; Aged ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*diagnosis/epidemiology/immunology ; Antineutrophil Cytoplasmic Antibodies ; Cross-Sectional Studies ; Female ; Granulomatosis with Polyangiitis/diagnosis/epidemiology/*immunology ; Humans ; Microscopic Polyangiitis/diagnosis/epidemiology/*immunology ; Middle Aged ; *Neutrophils ; Predictive Value of Tests ; Quality of Life ; *Recurrence ; Retrospective Studies ; Risk ; Severity of Illness Index
Delta neutrophil index ; granulomatosis with polyangiitis ; microscopic polyangiitis ; vasculitis activity
PURPOSE: Delta neutrophil index (DNI) represents the immature granulocytes count associated with neutrophil-consumption. We investigated whether DNI might be associated with Birmingham vasculitis activity score (BVAS) at diagnosis and could predict relapse during the follow-up in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). MATERIALS AND METHODS: We reviewed the medical records of 97 patients having DNI results. Twenty patients had granulomatosis with polyangiitis (GPA), 58 had microscopic polyangiitis (MPA), and 19 had eosinophilic GPA (EGPA). We collected clinical and laboratory data including BVAS, five factor score (FFS), and DNI. The correlation coefficient and cumulative relapse free survival rate were obtained. The optimal cut-off of DNI was extrapolated by calculating the area under the receiver operator characteristic curve. RESULTS: DNI was significantly related to cross-sectional BVAS. Furthermore, among continuous variables, only DNI could reflect BVAS of GPA and MPA, but not EGPA. Severe AAV was defined as BVAS >/=20 (the highest quartile). At diagnosis, patients having DNI >/=0.65% had a significantly higher risk of severe GPA and MPA than those having not (relative risk 4.255) at diagnosis. During the follow-up, DNI >/=0.65% could predict the higher relapse rate. CONCLUSION: DNI could reflect BVAS at diagnosis and furthermore, DNI >/=0.65% could not only identify severe AAV at diagnosis, but also predict relapse during the follow-up in patients with GPA and MPA.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
Song, Jungsik Jason(송정식) ORCID logo https://orcid.org/0000-0003-0662-7704
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-9002-9880
Yoo, Juyoung(유주영) ORCID logo https://orcid.org/0000-0001-8882-1695
Lee, Sang Won(이상원) ORCID logo https://orcid.org/0000-0002-8038-3341
Jung, Seung Min (정승민) ORCID logo https://orcid.org/0000-0003-3465-2181
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