title: Clinical analysis of patients with myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis.
abstract: This prospective study analyzed the clinical characteristics of myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-associated vasculitis and explored the relationship between MPO-ANCA and clinical manifestations of the associated vasculitis in 132 p-ANCA and MPO-ANCA-positive patients (average age, 62.3 ± 14.8 years) who were initially diagnosed with ANCA-associated vasculitis. The p-ANCA and MPO-ANCA levels in peripheral blood were detected in all patients. Among these, 128 (97%) had microscopic polyangiitis (MPA), 3 (2.3%) had granulomatous polyangiitis, and 1 (0.7%) had eosinophilic granulomatous vasculitis. The average time of diagnosis was 10.2 ± 18 months; only 14 (10.6%) patients were diagnosed within 1 month. The main organs involved and the corresponding number of patients were: renal, 95 (72%); lung, 89 (67.4%); joints, 35 (26.5%); heart, 26 (19.7%); peripheral nerve, 23 (17.4%); skin rash, 14 (10.6%); and CNS, 13 (9.8%). Older patients were more likely to show lung involvement in the early disease stage, whereas the joints were involved mostly in the younger patients. The p-ANCA levels (mean titers, 1:60) were not correlated with disease activity and extent of organ involvement, and the MPO-ANCA levels were positively correlated with disease activity, but had no correlation with the extent of organ involvement. MPO-ANCA vasculitis is a common occurrence in China; it mainly involves the elderly and presents as clinical manifestations of MPA. However, the multiple organ damage is not specific leading to delay in diagnosis. MPO-ANCA may play a pathogenic role in the associated vasculitis, and the diverse clinical manifestations might be related with the different characteristics of MPO-ANCA.
authors.affiliation: Department of Rheumatology, First Affiliated Hospital of Medical University of Anhui, Hefei, China shuaizongwen_zw@163.com.
authors.forename: Z W
authors.initials: ZW
authors.lastname: Shuai
authors.affiliation: Department of Rheumatology, First Affiliated Hospital of Medical University of Anhui, Hefei, China.
authors.forename: Y F
authors.initials: YF
authors.lastname: Lv
authors.affiliation: Department of Rheumatology, First Affiliated Hospital of Medical University of Anhui, Hefei, China.
authors.forename: M M
authors.initials: MM
authors.lastname: Zhang
authors.affiliation: Department of Rheumatology, First Affiliated Hospital of Medical University of Anhui, Hefei, China.
authors.forename: Z Y
authors.initials: ZY
authors.lastname: Hu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000097:blood* / Q000276:immunology / Q000473:pathology; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology / Q000473:pathology; D009195:Peroxidase / Q000097:blood* / Q000276:immunology; D011446:Prospective Studies
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D009195:Peroxidase