Watts Richard A, Scott David G I, Jayne David R W, Ito-Ihara Toshiko, Muso Eri, Fujimoto Shouichi, Harabuchi Yasuki, Kobayashi Shigeto, Suzuki Kazuo, Hashimoto Hiroshi
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.
Nephrol Dial Transplant. 2008 Dec;23(12):3928-31. doi: 10.1093/ndt/gfn354. Epub 2008 Jun 19.
The epidemiology of renal vasculitis in different populations is poorly understood. A recent study from Japan suggests that whilst the overall incidence is similar to that reported from Europe, the clinical phenotype is different, with Wegener's granulomatosis being very much less common. The aim of this study was to compare the incidence of renal vasculitis in the UK with recent data from a Japanese population. Methods. Incident patients with renal vasculitis were identified prospectively between 2000 and 2004 from a well-defined UK population. The case notes were reviewed and clinical features extracted. Classification between Wegener's granulomatosis, microscopic polyangiitis and Churg Strauss syndrome was performed using a predetermined algorithm. Inclusion criteria were (i) new patients with vasculitis with or without histological confirmation, (ii) renal involvement and (iii) positive serology for anti-neutrophil cytoplasmic antibody (ANCA).
We identified 27 cases of renal vasculitis (Wegener's granulomatosis 13, microscopic polyangiitis 11, Churg Strauss syndrome 3) fulfilling the case definition. The overall average age was 63.5 years which is less than those of the Japanese patients. The overall annual incidence of renal vasculitis was 12.2/million similar to Japan. The annual incidence of Wegener's granulomatosis was 5.8/million, microscopic polyangiitis 4.9/million and Churg Strauss syndrome 1.4/million. ENT and neurological involvement were much less common in Japan. No patients with cANCA/PR3 were seen in Japan. Wegener's granumolatosis seems to be much less common in Japan than the UK. Discussion. Whilst the overall occurrence of renal vasculitis is similar in Japan to the UK, the clinical phenotype is very different with microscopic polyangiitis predominating in Japan.
不同人群中肾血管炎的流行病学情况尚未得到充分了解。日本最近的一项研究表明，虽然总体发病率与欧洲报道的相似，但临床表型有所不同，韦格纳肉芽肿病的发病率要低得多。本研究的目的是比较英国肾血管炎的发病率与日本人群的近期数据。方法：在2000年至2004年间，从明确界定的英国人群中前瞻性地识别出肾血管炎的新发患者。查阅病历并提取临床特征。使用预定算法对韦格纳肉芽肿病、显微镜下多血管炎和变应性肉芽肿性血管炎进行分类。纳入标准为：（i）有或无组织学证实的血管炎新患者；（ii）肾脏受累；（iii）抗中性粒细胞胞浆抗体（ANCA）血清学阳性。
我们确定了27例符合病例定义的肾血管炎患者（韦格纳肉芽肿病13例，显微镜下多血管炎11例，变应性肉芽肿性血管炎3例）。总体平均年龄为63.5岁，低于日本患者。肾血管炎的总体年发病率为12.2/百万，与日本相似。韦格纳肉芽肿病的年发病率为5.8/百万，显微镜下多血管炎为4.9/百万，变应性肉芽肿性血管炎为1.4/百万。耳鼻喉科和神经系统受累在日本要少见得多。在日本未发现cANCA/PR3阳性的患者。韦格纳肉芽肿病在日本似乎比在英国少见得多。讨论：虽然日本肾血管炎的总体发病率与英国相似，但临床表型差异很大，显微镜下多血管炎在日本占主导地位。
