Respiratory investigation · 2026
Differences in chest HRCT findings in relation to ANCA subtypes in ANCA-associated vasculitis.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Usui Yusuke, Sakamoto Susumu, Homma Sakae, Kurosaki Atsuko, Kurihara Yasuyuki, Sato Keita, Suzuki Aika, Nanki Toshihiro, Arimura Yoshihiro, Matsuo Seiichi, Makino Hirofumi, Okada Yasunori, Harigai Masayoshi, Yamagata Kunihiro, Sugiyama Hitoshi, Dobashi Hiroaki, Ishizu Akihiro, Tsuboi Naotake, Usui Joichi, Sada Ken-Ei, Kishi Kazuma, Research Committee of Intractable Vasculitis Syndrome and Research Committee of Intractable Renal Disease of the Ministry of Health, Labour, and Welfare of Japan
Аннотация
BACKGROUND: Differences in chest HRCT findings between myeloperoxidase (MPO)- antineutrophil cytoplasmic antibody (ANCA) and proteinase 3 (PR3)-ANCA in Japanese patients with ANCA-associated vasculitis (AAV) remain unclear.
METHODS: We reviewed chest HRCT findings at diagnosis in 195 patients with AAV enrolled in the Remission Induction Therapy in Japanese Patients with ANCA-associated Vasculitis and Rapidly Progressive Glomerulonephritis (RemIT-JAV-RPGN) observational cohort study (2011-2013). Findings were classified by ANCA subtype and compared.
RESULTS: Abnormal chest HRCT findings were observed in 172 of 195 patients. Main findings included ground-glass opacity (n = 92, 47%), reticulation (n = 79, 41%), traction bronchiectasis (n = 67, 34%), and honeycombing (n = 4 9, 25%). Honeycombing (n = 46, 29%) and reticulation (n = 70, 43%) predominated in patients with positive MPO-ANCA, whereas nodules (n = 4, 44%) and cavities (n = 3, 33%) were more frequent in those with positive PR3-ANCA. Interstitial pneumonia (IP) was diagnosed in 89 patients, with HRCT patterns of definite usual interstitial pneumonia (UIP) in 31 (35%), possible UIP in 22 (25%), and inconsistent with UIP in 36 (40%). IP was more frequent in patients with positive MPO-ANCA than in those with positive PR3-ANCA (47% vs 11%, respectively; p = 0.003). Definite UIP was more common in MPO-ANCA positivity than in other subtypes (41% vs 0%, respectively; p = 0.023).
CONCLUSIONS: In Japanese patients with AAV, IP with a definite UIP pattern was more frequent in patients with MPO-ANCA positivity while nodules and cavities were more frequent in patients with positive PR3-ANCA.
METHODS: We reviewed chest HRCT findings at diagnosis in 195 patients with AAV enrolled in the Remission Induction Therapy in Japanese Patients with ANCA-associated Vasculitis and Rapidly Progressive Glomerulonephritis (RemIT-JAV-RPGN) observational cohort study (2011-2013). Findings were classified by ANCA subtype and compared.
RESULTS: Abnormal chest HRCT findings were observed in 172 of 195 patients. Main findings included ground-glass opacity (n = 92, 47%), reticulation (n = 79, 41%), traction bronchiectasis (n = 67, 34%), and honeycombing (n = 4 9, 25%). Honeycombing (n = 46, 29%) and reticulation (n = 70, 43%) predominated in patients with positive MPO-ANCA, whereas nodules (n = 4, 44%) and cavities (n = 3, 33%) were more frequent in those with positive PR3-ANCA. Interstitial pneumonia (IP) was diagnosed in 89 patients, with HRCT patterns of definite usual interstitial pneumonia (UIP) in 31 (35%), possible UIP in 22 (25%), and inconsistent with UIP in 36 (40%). IP was more frequent in patients with positive MPO-ANCA than in those with positive PR3-ANCA (47% vs 11%, respectively; p = 0.003). Definite UIP was more common in MPO-ANCA positivity than in other subtypes (41% vs 0%, respectively; p = 0.023).
CONCLUSIONS: In Japanese patients with AAV, IP with a definite UIP pattern was more frequent in patients with MPO-ANCA positivity while nodules and cavities were more frequent in patients with positive PR3-ANCA.