PURPOSE: We investigated whether red blood cell distribution width (RDW) predicts vasculitis activity based on Birmingham vasculitis activity score (BVAS) or BVAS for granulomatosis with polyangiitis (GPA) at diagnosis and poor prognosis during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). MATERIALS AND METHODS: We reviewed the medical records of 150 patients with AAV. We defined severe GPA as BVAS for GPA ≥7 (the highest quartile). Correlation and standardised correlation coefficients were analysed by linear regression tests. The differences between groups were evaluated by Mann-Whitney test. Relative risk (RR) was assessed by chi square test and Cox hazards model. RESULTS: RDW was correlated only with the vasculitis activity of GPA among patients with AAV. An increase in RDW was associated with the absence of ear nose throat (ENT) manifestation, but not proteinase 3-ANCA. Significant differences were noted in cumulative refractory free survival according to RDW ≥15.4% (p=0.007) and the absence of ENT manifestation (p=0.036). Multivariate Cox hazards analysis identified RDW ≥15.4% as the only significant predictor of refractory disease in GPA (RR 17.573). CONCLUSION: RDW predicts vasculitis activity in GPA, and RDW ≥15.4% at diagnosis may increase the risk of severe GPA at diagnosis and predict refractory diseases during follow-up.
Aged ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*blood/diagnosis ; *Erythrocyte Indices ; Female ; Follow-Up Studies ; Granulomatosis with Polyangiitis/*blood/diagnosis ; Humans ; Linear Models ; Middle Aged ; Multivariate Analysis ; Prognosis

OBJECTIVETo improve the diagnostic accuracy of Wegener's granulomatosis (WG) with pulmonary involvement by analyzing the clinical data and chest radiographic features.

METHODSThe clinical data and chest radiographic features of 43 WG cases with pulmonary involvement were retrospectively analyzed.

RESULTSClinically, the patients frequently presented with multi-system involvement, with the incidence of pulmonary involvement of 72.8%. The patients with WG presented with such symptoms in the respiratory system as coughing, expectoration, hemoptysis, and dyspnea. The radiographic manifestations varied among the cases. Nodules and cavitations in the lungs were the signs most frequently found, and patchy infiltration and bronchial narrowing were also observed, which often led to misdiagnosis of WG as other pulmonary diseases.

CONCLUSIONWG often has multi-organ involvement, and the lung is one of the most commonly involved organs. The clinical symptoms and radiographic manifestations of WG have no specificity, and the disease can be easily misdiagnosed. Biopsy and ANCA assay can be important means for WG diagnosis.

Adolescent ; Adult ; Aged ; Antibodies, Antineutrophil Cytoplasmic ; blood ; Biopsy, Needle ; Diagnostic Errors ; Female ; Granulomatosis with Polyangiitis ; complications ; diagnosis ; diagnostic imaging ; Humans ; Lung ; diagnostic imaging ; pathology ; Lung Diseases ; diagnostic imaging ; etiology ; pathology ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Young Adult