Clinical value of antineutrophil cytoplasmic antibody in eosinophilic granulomatosis with polyangiitis
10.3760/cma.j.issn.1007-7480.2018.06.004
- VernacularTitle:抗中性粒细胞胞质抗体在嗜酸性肉芽肿性多血管炎临床表型中的意义
- Author:
Ling GUO
1
,
2
;
Li WANG
;
Qingjun WU
;
Wenjie ZHENG
;
Xinping TIAN
;
Yong HOU
;
Mengtao LI
;
Xiaofeng ZENG
;
Fengchun ZHANG
Author Information
1. 100730 中国医学科学院北京协和医学院北京协和医院风湿免疫科
2. 山东省东营市人民医院风湿免疫科
- Keywords:
Polyangiitis;
Phenotype;
Churg-Strauss syndrome;
Antineutrophil cytoplasmic antibody
- From:
Chinese Journal of Rheumatology
2018;22(6):376-380
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of antineutrophil cytoplasmic antibody (ANCA) in clinical phenotype of eosinophilic granulomatosis with polyangiitis (EGPA).Methods The clinical data of 64 patients with EGPA from Peking Union Medical College Hospital between 2007 to 2016 were retrospectively analyzed,and the patients were followed up.Characteristics of patients with ANCA positive and ANCA negative were compared by independent-samples t test,Mann-Whitney U test and Chi-square test.Results Among 64 patients with EGPA,12(19％) were serum ANCA positive and 52(81％) were negative.The incidence of fever (77％ vs 35％,x2=9.403,P=0.002) and renal involvement,including proteinuria (67％ vs 25％,x2=7.678,P=0.006),hematuria (58％ vs 8％,x2=17.57,P＜0.01),renal inadequacy (33％ vs 4％,x2=9.978,P=0.002),and the BVAS score higher than 15 (92％ vs 60％,x2=4.440,P=0.035) in ANCA positive group were higher than ANCA negative group,while the presence of allergic rhinitis (17％ vs 56％,x2=5.969,P=0.015),mucocutaneous lesion (33％ vs 65％,x2=4.152,P=0.042) and cardiac involvement (8％ vs 44％,x2=3.361,P=0.021) in the ANCA-positive group was lower when compared with ANCA-negative patients.The positive ratio of rheumatoid factor (RF) (100％ vs 42％,x2=7.723,P=0.006),and the level of erythrocyte sedimentation rate (ESR) (50 vs 35.5 mm/1 h,P=0.034) in ANCA-positive group were higher than in ANCA negative group.There was no significant difference in pathological characteristics between the two groups.According to the treatment and prognosis,there were no significant differences between the two groups in the usage and dosage of steroids and immunosuppressant,the remission rate and recurrence rate of the disease,and the death rate due to the primary disease.Conclusion The clinical manifestations of EGPA are complicate.Whether ANCA is positive or not may be related to the clinical phenotypes.More attention should be paid to renal involvement in ANCA positive patients while cardiac involvement in ANCA negative patients.
