Skip to main content
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 2005 Nov;81(961):723–727. doi: 10.1136/pgmj.2005.034215

Cinical and pathological characteristics of Chinese patients with antineutrophil cytoplasmic autoantibody associated systemic vasculitides: a study of 426 patients from a single centre

M Chen, F Yu, Y Zhang, M Zhao
PMCID: PMC1743382  PMID: 16272238

Abstract

Background: Antineutrophil cytoplasmic autoantibodies (ANCA) are serological markers of ANCA associated systemic vasculitides (AASV), which is one of the most common multisystem autoimmune diseases. Features of Chinese patients with AASV have not been fully investigated.

Objective: To analyse the clinical and pathological characteristics of Chinese patients with AASV.

Methods: 426 Chinese patients with AASV diagnosed in the past eight years were retrospectively studied and their clinical and pathological data were analysed.

Results: Of the 426 patients, 87 (20.4%) were Wegener's granulomatosis, 337 (79.1%) were microscopic polyangiitis and two (0.5%) were Churg-Strauss syndrome. Only 201 of 426 (47.2%) patients were diagnosed within three months. Clinically, the patients had multisystem involvement. Altogether 371 of 426 (87.1%) had kidney involvement and 260 of 426 (61.0%) had lung involvement. The prevalences of renal involvement and fatigue were significantly higher in patients with MPO-ANCA than that in patients with PR3-ANCA; the prevalences of ophthalmic, nasal involvement, rash, and arthragia were significantly higher in patients with PR3-ANCA than those in patients with MPO-ANCA. The one and five year death rates were 13.1% and 22.4%, respectively. The percentage of patients progressing to end stage renal disease at one and five years was 15.9% and 27.1%, respectively.

Conclusions: AASV is not a rare autoimmune disease in Chinese people. Kidney and lung were the most vulnerable organs. For patients with multiorgan damage, an ANCA test should be performed to make an early diagnosis and to start treatment in time.

Full Text

The Full Text of this article is available as a PDF (71.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bajema I. M., Hagen E. C., Hermans J., Noël L. H., Waldherr R., Ferrario F., Van Der Woude F. J., Bruijn J. A. Kidney biopsy as a predictor for renal outcome in ANCA-associated necrotizing glomerulonephritis. Kidney Int. 1999 Nov;56(5):1751–1758. doi: 10.1046/j.1523-1755.1999.00758.x. [DOI] [PubMed] [Google Scholar]
  2. Booth Anthony D., Almond Mike K., Burns Aine, Ellis Peter, Gaskin Gill, Neild Guy H., Plaisance Martin, Pusey Charles D., Jayne David R. W., Pan-Thames Renal Research Group Outcome of ANCA-associated renal vasculitis: a 5-year retrospective study. Am J Kidney Dis. 2003 Apr;41(4):776–784. doi: 10.1016/s0272-6386(03)00025-8. [DOI] [PubMed] [Google Scholar]
  3. Franssen C. F., Stegeman C. A., Kallenberg C. G., Gans R. O., De Jong P. E., Hoorntje S. J., Tervaert J. W. Antiproteinase 3- and antimyeloperoxidase-associated vasculitis. Kidney Int. 2000 Jun;57(6):2195–2206. doi: 10.1046/j.1523-1755.2000.00080.x. [DOI] [PubMed] [Google Scholar]
  4. Franssen C., Gans R., Kallenberg C., Hageluken C., Hoorntje S. Disease spectrum of patients with antineutrophil cytoplasmic autoantibodies of defined specificity: distinct differences between patients with anti-proteinase 3 and anti-myeloperoxidase autoantibodies. J Intern Med. 1998 Sep;244(3):209–216. doi: 10.1046/j.1365-2796.1998.00357.x. [DOI] [PubMed] [Google Scholar]
  5. Gonzalez-Gay Miguel A., Garcia-Porrua Carlos, Guerrero Jose, Rodriguez-Ledo Pilar, Llorca Javier. The epidemiology of the primary systemic vasculitides in northwest Spain: implications of the Chapel Hill Consensus Conference definitions. Arthritis Rheum. 2003 Jun 15;49(3):388–393. doi: 10.1002/art.11115. [DOI] [PubMed] [Google Scholar]
  6. Hagen E. C., Daha M. R., Hermans J., Andrassy K., Csernok E., Gaskin G., Lesavre P., Lüdemann J., Rasmussen N., Sinico R. A. Diagnostic value of standardized assays for anti-neutrophil cytoplasmic antibodies in idiopathic systemic vasculitis. EC/BCR Project for ANCA Assay Standardization. Kidney Int. 1998 Mar;53(3):743–753. doi: 10.1046/j.1523-1755.1998.00807.x. [DOI] [PubMed] [Google Scholar]
  7. Hoffman G. S., Kerr G. S., Leavitt R. Y., Hallahan C. W., Lebovics R. S., Travis W. D., Rottem M., Fauci A. S. Wegener granulomatosis: an analysis of 158 patients. Ann Intern Med. 1992 Mar 15;116(6):488–498. doi: 10.7326/0003-4819-116-6-488. [DOI] [PubMed] [Google Scholar]
  8. Jennette J. C., Falk R. J., Andrassy K., Bacon P. A., Churg J., Gross W. L., Hagen E. C., Hoffman G. S., Hunder G. G., Kallenberg C. G. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum. 1994 Feb;37(2):187–192. doi: 10.1002/art.1780370206. [DOI] [PubMed] [Google Scholar]
  9. Kamesh Lavanya, Harper Lorraine, Savage Caroline O. S. ANCA-positive vasculitis. J Am Soc Nephrol. 2002 Jul;13(7):1953–1960. doi: 10.1097/01.asn.0000016442.33680.3e. [DOI] [PubMed] [Google Scholar]
  10. Lightfoot R. W., Jr, Michel B. A., Bloch D. A., Hunder G. G., Zvaifler N. J., McShane D. J., Arend W. P., Calabrese L. H., Leavitt R. Y., Lie J. T. The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum. 1990 Aug;33(8):1088–1093. doi: 10.1002/art.1780330805. [DOI] [PubMed] [Google Scholar]
  11. Reinhold-Keller E., Herlyn K., Wagner-Bastmeyer R., Gutfleisch J., Peter H. H., Raspe H. H., Gross W. L. No difference in the incidences of vasculitides between north and south Germany: first results of the German vasculitis register. Rheumatology (Oxford) 2002 May;41(5):540–549. doi: 10.1093/rheumatology/41.5.540. [DOI] [PubMed] [Google Scholar]
  12. Stone John H., Wegener's Granulomatosis Etanercept Trial Research Group Limited versus severe Wegener's granulomatosis: baseline data on patients in the Wegener's granulomatosis etanercept trial. Arthritis Rheum. 2003 Aug;48(8):2299–2309. doi: 10.1002/art.11075. [DOI] [PubMed] [Google Scholar]
  13. Tse W. Y., Cockwell P., Savage C. O. Assessment of disease activity in systemic vasculitis. Postgrad Med J. 1998 Jan;74(867):1–6. doi: 10.1136/pgmj.74.867.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Vassilopoulos Dimitrios, Niles John L., Villa-Forte Alexandra, Arroliga Alejandro C., Sullivan Eugene J., Merkel Peter A., Hoffman Gary S. Prevalence of antineutrophil cytoplasmic antibodies in patients with various pulmonary diseases or multiorgan dysfunction. Arthritis Rheum. 2003 Apr 15;49(2):151–155. doi: 10.1002/art.10997. [DOI] [PubMed] [Google Scholar]
  15. Wang Yue, Zhao Ming-Hui, Yu Jing, Xin Gang, Liu Yu-Chung, Zhang You-Kang, Wang Hai-Yan. The clinical and pathological characteristics of Chinese elderly patients with anti-neutrophil cytoplasmic autoantibodies associated small vessel vasculitis. Exp Gerontol. 2004 Sep;39(9):1401–1405. doi: 10.1016/j.exger.2004.05.004. [DOI] [PubMed] [Google Scholar]
  16. Watts R. A., Carruthers D. M., Scott D. G. Epidemiology of systemic vasculitis: changing incidence or definition? Semin Arthritis Rheum. 1995 Aug;25(1):28–34. doi: 10.1016/s0049-0172(95)80015-8. [DOI] [PubMed] [Google Scholar]
  17. Watts R. A., Lane S. E., Scott D. G., Koldingsnes W., Nossent H., Gonzalez-Gay M. A., Garcia-Porrua C., Bentham G. A. Epidemiology of vasculitis in Europe. Ann Rheum Dis. 2001 Dec;60(12):1156–1157. doi: 10.1136/ard.60.12.1156a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Watts Richard A., Scott David G. I. Epidemiology of the vasculitides. Curr Opin Rheumatol. 2003 Jan;15(1):11–16. doi: 10.1097/00002281-200301000-00003. [DOI] [PubMed] [Google Scholar]
  19. Watts Richard A., Scott David G. I. Epidemiology of the vasculitides. Curr Opin Rheumatol. 2003 Jan;15(1):11–16. doi: 10.1097/00002281-200301000-00003. [DOI] [PubMed] [Google Scholar]
  20. Xin Gang, Zhao Ming-Hui, Wang Hai-Yan. Detection rate and antigenic specificities of antineutrophil cytoplasmic antibodies in chinese patients with clinically suspected vasculitis. Clin Diagn Lab Immunol. 2004 May;11(3):559–562. doi: 10.1128/CDLI.11.3.559-562.2004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Yu Feng, Zhao Ming-hui, Huang Jian-ping, Yao Yong, Zou Wan-zhong, Zhang You-kang, Wang Hai-yan. [Clinical and pathological features of anti-neutrophil cytoplasm antibody associated systemic vasculitis in children]. Zhonghua Er Ke Za Zhi. 2003 Nov;41(11):831–834. [PubMed] [Google Scholar]
  22. Zhao M. H., Lockwood C. M. A comprehensive method to purify three major ANCA antigens: proteinase 3, myeloperoxidase and bactericidal/permeability-increasing protein from human neutrophil granule acid extract. J Immunol Methods. 1996 Oct 16;197(1-2):121–130. doi: 10.1016/0022-1759(96)00123-8. [DOI] [PubMed] [Google Scholar]
  23. Zhao M. H., Wang H. Y., Zhang Y. K. [The renal involvement of primary vasculitis: clinical and pathological analysis of 5 cases]. Zhonghua Nei Ke Za Zhi. 1993 Jan;32(1):40–43. [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES