Clinical implication of chronic paranasal sinusitis for the classification of microscopic polyangiitis

Hyeok Chan Kwon, Sung Soo Ahn, Seung Min Jung, Jason Jungsik Song, Yong Beom Park, Sang Won Lee

Research output: Contribution to journalArticle

Abstract

Background: Chronic paranasal sinusitis (CPS) has been known as a surrogate marker for granulomatosis with polyangiitis (GPA). We investigated whether CPS at diagnosis may have an influence on the classification and outcomes of microscopic polyangiitis (MPA). Methods: We retrospectively reviewed the medical records of 106 immunosuppressive drug-naïve patients with MPA. We compared variables at diagnosis of MPA patients with CPS with either MPA patients without CPS or 29 GPA patients with CPS. We applied the algorithm for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) proposed by the European Medicine Agency to 22 MPA patients with CPS and reclassify them. Death, relapse and end-stage renal disease were assessed as the poor outcomes. Results: Except for ENT manifestations, only pulmonary manifestation was more frequently observed in MPA patients with CPS than those without (77.3% vs 47.6%). No proteinase 3-ANCA was detected in all MPA patients with CPS. Meanwhile, general (63.6% vs 27.6%) and renal manifestations (81.8% vs 44.8%) more often developed in MPA patients with CPS than GPA patients with CPS. Of 22 MPA patients with CPS, 21 patients underwent biopsies. When CPS was not considered as a surrogate marker for GPA, all patients with CPS were reclassified as MPA. Ground glass opacity and reticulation on high-resolution computed tomography and renal vasculitis were helpful clues supporting the classification of MPA in patients with CPS. CPS at diagnosis was not associated with the outcomes of MPA. Conclusion: CPS might not be a sufficient surrogate marker for GPA in the classification of AAV.

Original languageEnglish
Article numbere13431
JournalInternational Journal of Clinical Practice
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Microscopic Polyangiitis
Sinusitis
Granulomatosis with Polyangiitis
Antineutrophil Cytoplasmic Antibodies
Biomarkers
Vasculitis
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Myeloblastin
Kidney

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Clinical implication of chronic paranasal sinusitis for the classification of microscopic polyangiitis",
abstract = "Background: Chronic paranasal sinusitis (CPS) has been known as a surrogate marker for granulomatosis with polyangiitis (GPA). We investigated whether CPS at diagnosis may have an influence on the classification and outcomes of microscopic polyangiitis (MPA). Methods: We retrospectively reviewed the medical records of 106 immunosuppressive drug-na{\"i}ve patients with MPA. We compared variables at diagnosis of MPA patients with CPS with either MPA patients without CPS or 29 GPA patients with CPS. We applied the algorithm for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) proposed by the European Medicine Agency to 22 MPA patients with CPS and reclassify them. Death, relapse and end-stage renal disease were assessed as the poor outcomes. Results: Except for ENT manifestations, only pulmonary manifestation was more frequently observed in MPA patients with CPS than those without (77.3{\%} vs 47.6{\%}). No proteinase 3-ANCA was detected in all MPA patients with CPS. Meanwhile, general (63.6{\%} vs 27.6{\%}) and renal manifestations (81.8{\%} vs 44.8{\%}) more often developed in MPA patients with CPS than GPA patients with CPS. Of 22 MPA patients with CPS, 21 patients underwent biopsies. When CPS was not considered as a surrogate marker for GPA, all patients with CPS were reclassified as MPA. Ground glass opacity and reticulation on high-resolution computed tomography and renal vasculitis were helpful clues supporting the classification of MPA in patients with CPS. CPS at diagnosis was not associated with the outcomes of MPA. Conclusion: CPS might not be a sufficient surrogate marker for GPA in the classification of AAV.",
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Clinical implication of chronic paranasal sinusitis for the classification of microscopic polyangiitis. / Kwon, Hyeok Chan; Ahn, Sung Soo; Jung, Seung Min; Song, Jason Jungsik; Park, Yong Beom; Lee, Sang Won.

In: International Journal of Clinical Practice, 01.01.2019.

Research output: Contribution to journalArticle

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T1 - Clinical implication of chronic paranasal sinusitis for the classification of microscopic polyangiitis

AU - Kwon, Hyeok Chan

AU - Ahn, Sung Soo

AU - Jung, Seung Min

AU - Song, Jason Jungsik

AU - Park, Yong Beom

AU - Lee, Sang Won

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N2 - Background: Chronic paranasal sinusitis (CPS) has been known as a surrogate marker for granulomatosis with polyangiitis (GPA). We investigated whether CPS at diagnosis may have an influence on the classification and outcomes of microscopic polyangiitis (MPA). Methods: We retrospectively reviewed the medical records of 106 immunosuppressive drug-naïve patients with MPA. We compared variables at diagnosis of MPA patients with CPS with either MPA patients without CPS or 29 GPA patients with CPS. We applied the algorithm for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) proposed by the European Medicine Agency to 22 MPA patients with CPS and reclassify them. Death, relapse and end-stage renal disease were assessed as the poor outcomes. Results: Except for ENT manifestations, only pulmonary manifestation was more frequently observed in MPA patients with CPS than those without (77.3% vs 47.6%). No proteinase 3-ANCA was detected in all MPA patients with CPS. Meanwhile, general (63.6% vs 27.6%) and renal manifestations (81.8% vs 44.8%) more often developed in MPA patients with CPS than GPA patients with CPS. Of 22 MPA patients with CPS, 21 patients underwent biopsies. When CPS was not considered as a surrogate marker for GPA, all patients with CPS were reclassified as MPA. Ground glass opacity and reticulation on high-resolution computed tomography and renal vasculitis were helpful clues supporting the classification of MPA in patients with CPS. CPS at diagnosis was not associated with the outcomes of MPA. Conclusion: CPS might not be a sufficient surrogate marker for GPA in the classification of AAV.

AB - Background: Chronic paranasal sinusitis (CPS) has been known as a surrogate marker for granulomatosis with polyangiitis (GPA). We investigated whether CPS at diagnosis may have an influence on the classification and outcomes of microscopic polyangiitis (MPA). Methods: We retrospectively reviewed the medical records of 106 immunosuppressive drug-naïve patients with MPA. We compared variables at diagnosis of MPA patients with CPS with either MPA patients without CPS or 29 GPA patients with CPS. We applied the algorithm for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) proposed by the European Medicine Agency to 22 MPA patients with CPS and reclassify them. Death, relapse and end-stage renal disease were assessed as the poor outcomes. Results: Except for ENT manifestations, only pulmonary manifestation was more frequently observed in MPA patients with CPS than those without (77.3% vs 47.6%). No proteinase 3-ANCA was detected in all MPA patients with CPS. Meanwhile, general (63.6% vs 27.6%) and renal manifestations (81.8% vs 44.8%) more often developed in MPA patients with CPS than GPA patients with CPS. Of 22 MPA patients with CPS, 21 patients underwent biopsies. When CPS was not considered as a surrogate marker for GPA, all patients with CPS were reclassified as MPA. Ground glass opacity and reticulation on high-resolution computed tomography and renal vasculitis were helpful clues supporting the classification of MPA in patients with CPS. CPS at diagnosis was not associated with the outcomes of MPA. Conclusion: CPS might not be a sufficient surrogate marker for GPA in the classification of AAV.

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