title: Assessment of autonomic function in a cohort of patients with ANCA-associated vasculitis.
abstract: To assess symptoms and objective parameters of autonomic dysfunction (AD) in patients with ANCA-associated vasculitides.
  
  
  
  Symptoms and objective parameters of AD were assessed in patients with ANCA-associated vasculitis and in age-matched healthy controls. Autonomic symptoms were explored by COMPASS31, a validated questionnaire addressing symptoms of six autonomic domains (orthostatic, vasomotor, secretomotor, gastrointestinal, pupillomotor, and bladder dysfunction). Objective autonomic parameters consisted of expiratory/inspiratory (E/I) ratio during the deep breathing test (DBT), blood pressure response to cold pressor test (CPT), and skin conductance changes during mental arithmetic.
  
  
  
  27 patients and 27 healthy controls have been enrolled. 27 patients and 27 controls completed COMPASS31. 21 patients and 18 controls underwent objective autonomic testing. Vasculitis patients had significantly higher COMPASS31 total scores than controls (median 10.4 vs 3.0; p = 0.005). In the sub-domain analysis, significant differences were seen in the vasomotor and the bladder domain (p = 0.004; p < 0.001, respectively). No correlation was found between COMPASS31 score and disease duration, number of affected organs, or Birmingham vasculitis activity score (BVAS). There was no significant difference in any of the objective autonomic parameters between patients and controls. In a subgroup analysis, no difference in objective autonomic parameters was found between patients with active disease (n = 12) and patients in remission (n = 7).
  
  
  
  Patients with ANCA-associated vasculitides commonly have symptoms of autonomic dysfunction that are independent of disease duration and disease severity. However, at least in this single-centre observation, there was no evidence of impaired autonomic regulation in three autonomic function tests in vasculitis patients.
authors.affiliation: Medizinische Klinik IV, Rheumaeinheit, Klinikum der Universität München, Munich, Germany. philipp.moog@mri.tum.de.|Abteilung für Nephrologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. philipp.moog@mri.tum.de.
authors.forename: P
authors.initials: P
authors.lastname: Moog
authors.affiliation: Neurologische Klinik und Poliklinik, Klinikum der Universität München, Munich, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Eren
authors.affiliation: Medizinische Klinik IV, Rheumaeinheit, Klinikum der Universität München, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Witt
authors.affiliation: Neurologische Klinik und Poliklinik, Klinikum der Universität München, Munich, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Rauschel
authors.affiliation: Medizinische Klinik IV, Rheumaeinheit, Klinikum der Universität München, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Kossegg
authors.affiliation: Neurologische Klinik und Poliklinik, Klinikum der Universität München, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Straube
authors.affiliation: Medizinische Klinik IV, Rheumaeinheit, Klinikum der Universität München, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Grünke
authors.affiliation: Medizinische Klinik IV, Rheumaeinheit, Klinikum der Universität München, Munich, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Schulze-Koops
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000503:physiopathology*; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D001794:Blood Pressure; D015267:Churg-Strauss Syndrome / Q000503:physiopathology; D015331:Cohort Studies; D003080:Cold Temperature; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D008297:Male; D055953:Microscopic Polyangiitis / Q000503:physiopathology; D008875:Middle Aged; D012119:Respiration; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: ANCA; Autonomic dysfunction; Autonomic neuropathy; Granulomatosis with polyangiitis; Heart rate variability; Microscopic polyangiitis; Vasculitis