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Rheumatoid factor positivity in antineutrophil cytoplasmic antibody-associated vasculitis: a distinct clinical entity or innocent bystander?

Authors
 Sung Soo Ahn  ;  Jang Woo Ha  ;  Yong-Beom Park  ;  Sang-Won Lee 
Citation
 RHEUMATOLOGY, Vol.61(4) : 1366-1375, 2022-04 
Journal Title
RHEUMATOLOGY
ISSN
 1462-0324 
Issue Date
2022-04
MeSH
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / complications ; Antibodies, Antineutrophil Cytoplasmic ; Humans ; Kidney Failure, Chronic* / complications ; Prognosis ; Retrospective Studies ; Rheumatoid Factor
Keywords
antineutrophil cytoplasmic antibody ; end-stage kidney disease ; general manifestation ; prognosis ; rheumatoid factor ; vasculitis
Abstract
Objective: To investigate the significance of RF positivity in ANCA-associated vasculitis (AAV) patients.

Methods: AAV patients were divided into groups as follows: RF (+)/ANCA (+) (n = 94), RF (-)/ANCA (+) (n = 80), RF (+)/ANCA (-) (n = 15) and RF (-)/ANCA (-) (n = 25). Their clinical data, organ involvement patterns, laboratory data, and patient outcomes were assessed. Kaplan-Meier analysis and propensity score matching (PSM) were performed to compare outcomes and analyse differences between the groups.

Results: Of the 214 patients, RF and ANCA positivity was found in 109 (50.9%) and 174 (81.3%) patients, respectively. RF (+)/ANCA (+) patients more frequently presented with general manifestations (58.5%) than the other groups. Additionally, compared with those of RF (-)/ANCA (+) group, RF (+)/ANCA (+) patients were older, had higher white blood cell, neutrophil, platelet counts and acute phase reactants; however, creatinine and albumin levels were lower. The end-stage kidney disease-free survival rate was significantly higher in the RF (+)/ANCA (+) group (P =0.013), while the proportion of renal involvement was comparable to the RF (-)/ANCA (+) group. PSM showed no difference in patient outcomes between the two groups after adjustment.

Conclusion: RF positivity was associated with a distinct phenotype in AAV patients. In particular, difference was observed in clinical features and outcomes between RF (+)/ANCA (+) and RF (-)/ANCA (+) groups, although the direct prognostic implication of RF was not evident.
Full Text
https://academic.oup.com/rheumatology/article/61/4/1366/6329840?login=false
DOI
10.1093/rheumatology/keab595
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-9002-9880
Lee, Sang-Won(이상원) ORCID logo https://orcid.org/0000-0002-8038-3341
Ha, Jang Woo(하장우)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188433
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