From the Department of Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen-EsSalud.
J Clin Rheumatol. 2021 Sep 1;27(6S):S246-S251. doi: 10.1097/RHU.0000000000001595.
The aim of this study was to identify the demographic and clinical features of patients with ANCA-associated vasculitides (AAVs) in a Peruvian tertiary referral hospital.
Medical records of patients with AAV according to classification criteria or diagnosed by an experienced rheumatologist, and covering the period between January 1990 and December 2019, were reviewed. Granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA), and renal-limited vasculitis (RLV) were included. Demographic factors (age at diagnosis, sex), disease duration, clinical manifestations (per organ involvement), creatinine level at diagnosis (milligram per deciliter), ANCA status, diagnosis, 2009 Five Factor Score, disease categorization, and treatment were recorded.
Two hundred twelve patients were included. Their female-to-male ratio was 1.9:1 (139 [65.6%]/73 [34.4%]), and their mean (SD) age at diagnosis was 59.2 (12.5) years. One hundred fifty-eight patients (74.5%) had MPA, 42 (19.8%) GPA, 7 (3.3%) RLV, and 5 (2.4%) EGPA. Neurological, lung, and renal involvements were the most frequently affected systems. Myeloperoxidase preferentially occurred in MPA (82.5%), whereas proteinase 3 did occur in GPA (79.5%). Microscopic polyangiitis patients were older (61.1 [11.5] years). Female sex predominated in MPA and RLV (2.4:1 and 6:1, respectively), but the opposite was the case for EGPA (1:4). Ear-nose-throat and ocular involvement were more frequent in GPA (both p's < 0.001), and neurological and cardiovascular involvement were more frequent in EGPA (p < 0.001 and p = 0.002, respectively).
This is one of the largest series of AAV patients in Latin America. Overall, female sex predominated. Microscopic polyangiitis was the most frequent AAV, and myeloperoxidase-ANCA was the most frequent antibody in Peruvian AAV population.
本研究旨在确定秘鲁一家三级转诊医院中抗中性粒细胞胞浆抗体（ANCA）相关性血管炎（AAV）患者的人口统计学和临床特征。
对 1990 年 1 月至 2019 年 12 月期间符合分类标准或由经验丰富的风湿病学家诊断为 AAV 的患者的病历进行了回顾性分析。包括肉芽肿性多血管炎（GPA）、显微镜下多血管炎（MPA）、嗜酸性肉芽肿性多血管炎（EGPA）和肾血管炎（RLV）。记录了人口统计学因素（诊断时的年龄、性别）、疾病持续时间、临床表现（累及器官）、诊断时的肌酐水平（毫克/分升）、ANCA 状态、诊断、2009 年五因素评分、疾病分类和治疗。
共纳入 212 例患者，女性与男性的比例为 1.9:1（139 例[65.6%]/73 例[34.4%]），诊断时的平均（标准差）年龄为 59.2（12.5）岁。158 例（74.5%）患者为 MPA，42 例（19.8%）为 GPA，7 例（3.3%）为 RLV，5 例（2.4%）为 EGPA。神经系统、肺部和肾脏受累是最常受影响的系统。髓过氧化物酶在 MPA 中更常见（82.5%），而蛋白酶 3 在 GPA 中更常见（79.5%）。显微镜下多血管炎患者年龄较大（61.1[11.5]岁）。女性在 MPA 和 RLV 中更为常见（2.4:1 和 6:1），而 EGPA 则相反（1:4）。GPA 患者的耳鼻喉和眼部受累更为常见（均 p 值<0.001），而 EGPA 患者的神经系统和心血管受累更为常见（均 p 值<0.001 和 p=0.002）。
这是拉丁美洲最大的 AAV 患者系列之一。总体而言，女性更为常见。显微镜下多血管炎是最常见的 AAV，而在秘鲁的 AAV 人群中，髓过氧化物酶-ANCA 是最常见的抗体。
