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探讨抗中性粒细胞胞浆抗体(ANCA)相关性血管炎与炎症性肠病(IBD)的共存情况。

Investigating the concomitance of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitides and inflammatory bowel disease (IBD).

机构信息

Division of Rheumatology (Mumtaz, Valecha, Berianu, Majithia and Abril), Mayo Clinic College of Medicine and Science, Jacksonville, FL, United States.

Division of Rheumatology (Mumtaz, Valecha, Berianu, Majithia and Abril), Mayo Clinic College of Medicine and Science, Jacksonville, FL, United States.

出版信息

Semin Arthritis Rheum. 2024 Jun;66:152452. doi: 10.1016/j.semarthrit.2024.152452. Epub 2024 Apr 23.

Abstract

OBJECTIVE

To assess relationship between Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis and inflammatory bowel disease (IBD).

METHODS

This is a retrospective study design. The patients were identified using a preset criteria of patients who have the diagnosis of ANCA associated vasculitis including a diagnosis of granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) or eosinophilic granulomatosis with polyangiitis (EGPA) with overlapping inflammatory bowel disease (Crohn's disease or ulcerative colitis) in the time period from 01/01/2020 to 08/03/2023. Subsequently data from each patient was collected that will include baseline demographics, disease characteristics, disease activity, treatment information, multiorgan involvement, and pathology findings which were then analyzed.

RESULTS

39 patients were identified that met criteria. 20 patients carried a diagnosis of GPA, 6 had MPA and 4 patients had EGPA. 20 patients with GPA had inflammatory bowel disease, 13 with ulcerative colitis and 6 with Crohn's disease while 1 GPA patient had unspecified inflammatory bowel disease. 4 patients with EGPA had inflammatory bowel disease, 2 with ulcerative colitis and 2 with Crohn's disease. 6 patients with MPA had inflammatory bowel disease, 4 with ulcerative colitis and 2 with Crohn's disease. IBD diagnosis preceded the diagnosis of ANCA vasculitis in 77.8 % of the cases.

CONCLUSION

Objective observation and deductions from this study raise the concern for a possible pathogenic association of ANCA associated vasculitis and inflammatory bowel disease and more research is needed to identify any causal association or influence of the two systemic disease on each other.

摘要

目的

评估抗中性粒细胞胞浆抗体(ANCA)相关性血管炎与炎症性肠病(IBD)之间的关系。

方法

这是一项回顾性研究设计。通过预设标准确定患者,即符合 ANCA 相关性血管炎诊断标准的患者,包括在 2020 年 1 月 1 日至 2023 年 8 月 3 日期间诊断为肉芽肿性多血管炎(GPA)或显微镜下多血管炎(MPA)或嗜酸性肉芽肿性多血管炎(EGPA),并伴有重叠性炎症性肠病(克罗恩病或溃疡性结肠炎)。随后收集每位患者的数据,包括基线人口统计学特征、疾病特征、疾病活动度、治疗信息、多器官受累和病理学发现,并进行分析。

结果

共确定 39 名符合标准的患者。20 名患者诊断为 GPA,6 名患者为 MPA,4 名患者为 EGPA。20 名 GPA 患者合并 IBD,其中 13 名溃疡性结肠炎,6 名克罗恩病,1 名 GPA 患者为未特指的 IBD。4 名 EGPA 患者合并 IBD,其中 2 名溃疡性结肠炎,2 名克罗恩病。6 名 MPA 患者合并 IBD,其中 4 名溃疡性结肠炎,2 名克罗恩病。IBD 的诊断先于 ANCA 血管炎的诊断,占 77.8%。

结论

本研究的客观观察和推论引起了对 ANCA 相关性血管炎与炎症性肠病之间可能存在致病关联的关注,需要进一步研究以确定这两种全身性疾病之间是否存在因果关联或相互影响。

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