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Acute Brain Infarction in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A Korean Single-Center Study

 Jang Woo Ha  ;  Joonnyung Heo  ;  Jung Yoon Pyo  ;  Sung Soo Ahn  ;  Jason Jungsik Song  ;  Yong-Beom Park  ;  Sang-Won Lee 
 JCR-JOURNAL OF CLINICAL RHEUMATOLOGY, Vol.29(5) : 217-222, 2023-08 
Journal Title
Issue Date
Acute Disease ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / complications ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / diagnosis ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / epidemiology ; Antibodies, Antineutrophil Cytoplasmic* ; Asian People ; Brain Infarction* / diagnosis ; Brain Infarction* / epidemiology ; Brain Infarction* / etiology ; Female ; Humans ; Male ; Middle Aged ; Republic of Korea / epidemiology ; Retrospective Studies
Objectives: This study investigated the clinical and radiological features of antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) patients with acute brain infarction, using a cohort of Korean patients with AAV.

Methods: This study included 263 patientswith AAV. Acute brain infarction was defined as infarction that occurred within 7 days or less. The brain territories affected by acute brain infarction were investigated. Active AAV was arbitrarily defined as the highest tertile of Birmingham Vasculitis Activity Score (BVAS).

Results: The median age at diagnosis was 59.0 years, and 35.4% were male. Fourteen cases of acute brain infarction occurred in 12 patients (4.6%), which was calculated as 1332.2 per 100,000 patient-years and 10 times higher than the incidence rate in the Korean general population. Patients with AAV with acute brain infarction exhibited significantly older age, increased BVAS at diagnosis, and a more frequent history of prior brain infarction compared with those without. The brain territories affected in AAV patients were middle cerebral artery (50.0%), multiple territories (35.7%), and posterior cerebral artery (14.3%). Lacunar infarction and microhemorrhage were observed in 42.9% and 71.4% of cases, respectively. Prior brain infarction and BVAS at diagnosis were independently associated with acute brain infarction (hazard ratios, 7.037 and 1.089). Patients with AAV with prior brain infarction or BVAS for active AAV exhibited significantly lower cumulative acute brain infarction–free survival
rates than those without.

Conclusion: Acute brain infarction was observed in 4.6% of AAV patients, and both prior brain infarction and BVAS at diagnosiswere independently associated with acute brain infarction.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
Song, Jason Jungsik(송정식) ORCID logo https://orcid.org/0000-0003-0662-7704
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
Pyo, Jung Yoon(표정윤)
Ha, Jang Woo(하장우)
Heo, JoonNyung(허준녕)
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