Ecclestone Tegwen, Watts Richard A
North West Anglia NHS Foundation Trust, UK.
Norwich Medical School, University of East Anglia, UK.
Best Pract Res Clin Rheumatol. 2023 Mar;37(1):101845. doi: 10.1016/j.berh.2023.101845. Epub 2023 Jul 18.
The recent publication of the American College of Rheumatology (ACR)-European Alliance of Associations for Rheumatology (EULAR) classification criteria for large vessel vasculitis and anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) has provided modern criteria for the classification of these conditions, which incorporate contemporary methods of investigation and diagnosis. Further validation is required in independent cohorts, especially from populations that were not well represented in the development cohort. Studies of the occurrence of large vessel vasculitis report that Takayasu arteritis is a rare disease in most populations, and giant cell arteritis is the most common vasculitis in older populations. The incidence of AAV appears to have plateaued, but the prevalence is increasing as a result of lower mortality. The new classification criteria may affect the reported incidence and prevalence, and studies will be needed to confirm this. The impact of COVID-19 on the occurrence of the vasculitides is not completely known, but there is evidence of reduced occurrence of Kawasaki disease and IgA-associated vasculitis following lockdowns with reduced transmission of possible trigger infectious agents.
美国风湿病学会(ACR)-欧洲风湿病协会联盟(EULAR)关于大血管血管炎和抗中性粒细胞胞浆抗体(ANCA)相关血管炎(AAV)的分类标准最近发表,为这些疾病的分类提供了现代标准,其中纳入了当代的调查和诊断方法。需要在独立队列中进行进一步验证,尤其是来自在开发队列中代表性不足的人群。关于大血管血管炎发病率的研究报告称,在大多数人群中,高安动脉炎是一种罕见疾病,而巨细胞动脉炎是老年人群中最常见的血管炎。AAV的发病率似乎已趋于平稳,但由于死亡率降低,患病率正在上升。新的分类标准可能会影响报告的发病率和患病率,需要进行研究来证实这一点。COVID-19对血管炎发生的影响尚不完全清楚,但有证据表明,在封锁措施减少了可能引发感染的病原体传播后,川崎病和IgA相关血管炎的发病率有所降低。