Common clinical pattern of antineutrophil cytoplasmic antibody -associated vasculitis: An experience from a multicenter study in Saudi Arabia

Jumanah J. Alfuwayris; Amal M. Almulhim; Mohammed A. Almansour; Marzouq A. Albadi; Ibrahim A. Alhomood; Faisal Alblewi; Abdullah U. Althemery

doi:10.15537/smj.2023.44.5.20220818

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Figure 1
- Means for laboratory parameters. CRP: C-reactive protein, ESR: erythrocyte sedimentation rate, Hg: hemoglobin, RBCs: red blood cells, HPF: high power field, WBC: white blood cell, EGPA: eosinophilic granulomatosis with polyangiitis, GPA: granulomatosis with polyangiitis, MPA: microscopic polyangiitis. *CRP was not needed for 2 patients with GPA. ^$ESR was not needed for one patients with GPA, ^&Urine samples were not collected from 4 patients with GPA and 4 patients with EGPA.24h urine protein was collected from only 1 patient: 4.9 g/L.
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Figure 2
- Common signs and symptoms in patients with eosinophilic granulomatosis with polyangiitis (EGPA) and GPA. EGPA: eosinophilic granulomatosis with polyangiitis, GPA: granulomatosis with polyangiitis. ^§8 of 18 patients with adult-onset asthma and 4 of 18 with refractory asthma. ^¥based on renal biopsy: (6) GPA patient with pauci-immune glomerulonephritis [4 of them with crescent], (1) GPA with rapid progressive glomerulonephritis, (1) GPA with pauci-immune and IgA deposit glomerulonephritis, (1) GPA with pauci-immune and focal segmental glomerulonephritis, (1) GPA with focal necrotizing proliferation glomerulonephritis with IgA deposits, (1) GPA with focal necrotizing glomerulonephritis, (2) GPA with focal segmental glomerulonephritis, (1) GPA with fibrous crescent, sclerosed glomerular tuft, and severe vascular changes. Renal biopsy was not performed in 2 GPA and 1 EGPA patients with renal manifestations of acute kidney injury, hematuria, or proteinuria.

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Table 1

- Frequencies for categorical paramters (variables).

Variables	EGPA	GPA	P-value	Total	MPA	Total
Variables	n (%)		P-value	n (%)
Number of patients	18	33		51	2	53
Average age (years)	40.17 (13.1)	43.61 (14.0)	0.39	42.39 (13.6)	53.50 (13.4)	42.81 (13.7)
Females	11 (61.1)	20 (60.6)	0.24	31 (60.8)	2 (100)	33 (62.3)
ANCA type			<0.0001
MPO	4 (22.2)	4 (12.1)		8 (15.7)	2 (100)	10 (18.9)
Negative	14 (77.8)	1 (3.1)		15 (29.4)	0 (0)	15 (28.3)
PR3	0 (0)	28 (84.9)		28 (54.9)	0 (0)	28 (52.8)
Systems
Upper airway	18 (100)	27 (81.8)	0.08	45 (88.2)	1 (50.0)	46 (86.8)
Pulmonary	18 (100)	24 (72.7)	0.02	42 (82.4)	1 (50.0)	43 (81.1)
Musculoskeletal	8 (44.4)	17 (51.5)	0.77	25 (49.0)	0 (0)	25 (47.2)
Constitutional	5 (27.8)	17 (51.5)	0.14	22 (43.1)	1 (50.0)	23 (43.4)
Renal	1 (5.6)	16 (48.5)	0.002	17 (33.3)	2 (100)	19 (35.9)
Neurology	11 (61.1)	3 (9.1)	0.001	14 (27.4)	1 (50.0)	15 (28.3)
Cutaneous	5 (27.8)	5 (15.2)	0.16	10 (19.6)	0 (0)	10 (18.9)
Cardiology	5 (27.8)	1 (3.1)	0.02	6 (11.8)	0 (0)	6 (11.3)
Gastroenterology	3 (16.7)	3 (9.1)	0.65	6 (11.8)	0 (0)	6 (11.3)
Ocular	1 (5.6)	4 (12.1)	0.64	5 (9.8)	0 (0)	5 (9.4)

EGPA: eosinophilic granulomatosis with polyangiitis, GPA: granulomatosis with polyangiitis, MPA: microscopic polyangiitis, ANCA: antineutrophil cytoplasmic antibody, MPO: myeloperoxidase, PR3: proteinase-3