Department of Respiratory Medicine, University of Patras General Hospital, Patras, Greece; Department of Internal Medicine, University of Cyprus Medical School, Nicosia, Cyprus.
Department of Medicine, Division of Rheumatology, University of Arizona College of Medicine, Phoenix, AZ, USA; Department of Internal Medicine, Division of Rheumatology, University of Cyprus Medical School, Nicosia, Cyprus.
Clin Immunol. 2020 Nov;220:108595. doi: 10.1016/j.clim.2020.108595. Epub 2020 Sep 19.
We conducted a systematic review to identify cases of infection-induced anti-myeloperoxidase (MPO) antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).
PubMed/Medline databases were searched from inception to July of 2020, according to PRISMA guidelines.
Among the 618 abstracts identified, 18 articles describing 23 patients (60.9% female, mean age 50.5 years) were included. Median time between infection and vasculitis development was 3 months. Five (21.7%) patients expired during follow-up. Vasculitis regressed after the resolution of infection in 12/23 (52.2%). ANCA titers decreased significantly on follow-up in 14/16 patients and in all survivors in which they were measured. Pathogens reported included Mycobacterium spp., Coccidioides spp., Rickettsia rickettsii, Staphylococcus spp., EBV, CMV and Dengue virus.
MPO-AAV can occur after infection and may regress after its resolution. Infection should be considered in cases of MPO-AAV, as immunosuppressive treatment can have catastrophic results if the infection is not adequately treated.
我们进行了一项系统评价，以确定感染诱导的髓过氧化物酶（MPO）抗中性粒细胞胞质抗体（ANCA）相关性血管炎（AAV）病例。
根据 PRISMA 指南，从建立到 2020 年 7 月，我们在 PubMed/Medline 数据库中进行了搜索。
在确定的 618 篇摘要中，有 18 篇文章描述了 23 名患者（女性占 60.9%，平均年龄 50.5 岁）。感染与血管炎发生之间的中位时间为 3 个月。5 名（21.7%）患者在随访期间死亡。23 例患者中有 12 例（52.2%）在感染得到解决后血管炎消退。14/16 名患者的 ANCA 滴度在随访时显著下降，所有幸存者中均有测量。报告的病原体包括分枝杆菌属、球孢子菌属、立克次体属、葡萄球菌属、EBV、CMV 和登革热病毒。
MPO-AAV 可在感染后发生，且可能在感染解决后消退。如果感染未得到充分治疗，应考虑 MPO-AAV 病例中的感染，因为免疫抑制治疗可能会产生灾难性的结果。
