title: Respiratory manifestations of ANCA-associated vasculitis.
abstract: BACKGROUND
  The prevalence of pulmonary manifestations of ANCA-associated vasculitis (AAV) is not well understood. This study describes the prevalence of respiratory complications of AAV detected via imaging in patients presenting to a secondary renal centre and describes the associations with mortality.
  
  
  METHODS
  105 patients with AAV were identified from the Chronic Renal Insufficiency Standards Implementation Study (CRISIS). CRISIS is a prospective epidemiological study of patients with chronic kidney disease stages 3-5, both who did and did not require dialysis on presentation. Patients were recruited between 2000 and 2013.
  
  
  RESULTS
  A chest X-ray was performed in 81.0% of patients with AAV on presentation, of which 56.5% were abnormal. A computed tomography (CT) thorax was performed in 27 patients during the course of their disease: 92.6% showed abnormalities, most commonly fibrosis (63.0%) and bronchiectasis (44.4%). Pulmonary vascultitis was confirmed in 22 of 105 patients (21.0%) after respiratory review or demonstrated by associated changes associated on CT scan. In a Cox regression model, there was no significant association between pulmonary vasculitis and mortality (P = 0.088), although there was a trend towards increased mortality with pulmonary vasculitis.
  
  
  CONCLUSIONS
  Pulmonary manifestations of AAV were common, however only a small proportion of patients had had thorough respiratory investigations, suggesting that the pulmonary manifestations of AAV may be under-diagnosed.
authors.affiliation: School of Medicine, University of Manchester, Manchester, UK.
authors.forename: Kerry
authors.initials: K
authors.lastname: Greenan
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Vassallo
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK.
authors.forename: Rajkumar
authors.initials: R
authors.lastname: Chinnadurai
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK.
authors.forename: James
authors.initials: J
authors.lastname: Ritchie
authors.affiliation: Department of Respiratory Medicine, Royal Blackburn Hospital, Blackburn, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Shepherd
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK.|Manchester Academic Health Sciences Centre, Institute of Population Health, University of Manchester, Manchester, UK.
authors.forename: Darren
authors.initials: D
authors.lastname: Green
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK.
authors.forename: Arvind
authors.initials: A
authors.lastname: Ponnusamy
authors.affiliation: Vascular Research Group, Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, UK.|Manchester Academic Health Sciences Centre, Institute of Population Health, University of Manchester, Manchester, UK.
authors.forename: Smeeta
authors.initials: S
authors.lastname: Sinha
mesh_terms: D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000150:complications* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D006113:United Kingdom / Q000453:epidemiology
keywords: ANCA; respiratory; vasculitis