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Clinical application of low erythrocyte sedimentation rate/high C-reactive protein to antineutrophil cytoplasmic antibody-associated vasculitis

Authors
 Pil Gyu Park  ;  Jason Jungsik Song  ;  Yong-Beom Park  ;  Sang-Won Lee 
Citation
 JOURNAL OF CLINICAL LABORATORY ANALYSIS, Vol.36(2) : e24237, 2022-02 
Journal Title
JOURNAL OF CLINICAL LABORATORY ANALYSIS
ISSN
 0887-8013 
Issue Date
2022-02
Keywords
C-reactive protein ; antineutrophil cytoplasmic antibody ; erythrocyte sedimentation rate ; mortality ; vasculitis
Abstract
Background: This study investigated whether the discordance between erythrocyte sedimentation rate (ESR) and C-reactive protein at diagnosis could estimate the simultaneous clinical and laboratory variables and predict the poor outcomes during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).

Methods: The medical records of 254 AAV patients were reviewed. Clinical and laboratory and AAV-specific indices at diagnosis and all-cause mortality, relapse and end-stage renal disease during follow-up were obtained. ESR and CRP levels were categorised as high and low based on the median values. Accordingly, the patients were divided into the following four groups: high ESR/low CRP; low ESR/high CRP; low ESR/low CRP; and high ESR/high CRP.

Results: Of the 254 AAV patients, 51 patients exhibited discordance between ESR and CRP. Among the 51 AAV patients, the median age was 59.0 years, and 20 patients were men (29 MPA, 13 GPA and 9 EGPA). Cardiovascular and nervous systemic manifestations were observed more frequently in AAV patients with low ESR/high CRP than in those with high ESR/low CRP. Six patients from the low ESR/high CRP group died. AAV patients with low ESR/high CRP exhibited significantly lower cumulative patients' survival rates than both those with high ESR/low CRP and those with low ESR/low CRP. Also, AAV patients with low ESR/high CRP exhibited significantly higher simultaneous BVAS than those with low ESR/low CRP.

Conclusions: Low ESR/high CRP at diagnosis could not only estimate the simultaneous high BVAS but also predict all-cause mortality during follow-up in AAV patients.
Files in This Item:
T202200387.pdf Download
DOI
10.1002/jcla.24237
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
Park, Pil Gyu(박필규)
Song, Jason Jungsik(송정식) ORCID logo https://orcid.org/0000-0003-0662-7704
Lee, Sang-Won(이상원) ORCID logo https://orcid.org/0000-0002-8038-3341
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187985
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