Background: This study investigated whether the discordance between erythrocyte sedimentation rate (ESR) and C-reactive protein at diagnosis could estimate the simultaneous clinical and laboratory variables and predict the poor outcomes during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods: The medical records of 254 AAV patients were reviewed. Clinical and laboratory and AAV-specific indices at diagnosis and all-cause mortality, relapse and end-stage renal disease during follow-up were obtained. ESR and CRP levels were categorised as high and low based on the median values. Accordingly, the patients were divided into the following four groups: high ESR/low CRP; low ESR/high CRP; low ESR/low CRP; and high ESR/high CRP. Results: Of the 254 AAV patients, 51 patients exhibited discordance between ESR and CRP. Among the 51 AAV patients, the median age was 59.0 years, and 20 patients were men (29 MPA, 13 GPA and 9 EGPA). Cardiovascular and nervous systemic manifestations were observed more frequently in AAV patients with low ESR/high CRP than in those with high ESR/low CRP. Six patients from the low ESR/high CRP group died. AAV patients with low ESR/high CRP exhibited significantly lower cumulative patients' survival rates than both those with high ESR/low CRP and those with low ESR/low CRP. Also, AAV patients with low ESR/high CRP exhibited significantly higher simultaneous BVAS than those with low ESR/low CRP. Conclusions: Low ESR/high CRP at diagnosis could not only estimate the simultaneous high BVAS but also predict all-cause mortality during follow-up in AAV patients.
|Journal||Journal of Clinical Laboratory Analysis|
|Publication status||Published - 2022 Feb|
Bibliographical noteFunding Information:
This research was supported by a faculty research grant of Yonsei University College of Medicine (6‐2019‐0184) and a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (HI14C1324)
This research was supported by a faculty research grant of Yonsei University College of Medicine (6-2019-0184) and a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (HI14C1324) We thank Dr Yun Ho Roh (PhD; Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic Korea) for his statistical advice.
© 2022 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.
All Science Journal Classification (ASJC) codes
- Immunology and Allergy
- Public Health, Environmental and Occupational Health
- Clinical Biochemistry
- Medical Laboratory Technology
- Biochemistry, medical
- Microbiology (medical)