Patients with anti-neutrophil cytoplasmic antibody–associated vasculitides (AAV) have an increased risk of mortality. But treatments have evolved in recent years. Recent research found that between 1999 and 2017 the AAV mortality rate declined by nearly 2% per year in patients 65–74 years old…
The Classification & Diagnosis of Granulomatosis with Polyangiitis
Based on the classification system developed by the Chapel Hill Consensus Conference, anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis is defined as a necrotizing vasculitis involving small vessels that is associated with myeloperoxidase (MPO) ANCA or proteinase 3 (PR3) ANCA and displays minimal immune deposits. The mechanism behind the pathogenesis of ANCA-associated vasculitis is not fully…
Case Illustrates the Difficulty Diagnosing Granulomatosis with Polyangiitis
Granulomatosis with polyangiitis (GPA) was first described in the British Medical Journal in 1897 by Scottish otolaryngologist Peter McBride.1 GPA is a relatively rare, systemic necrotizing vasculitis that can make diagnosis challenging. The incidence has been estimated anywhere between two and 12 cases per million.2 GPA mainly affects adults between the ages of 45 and…
New Rheumatology Disease Research & Advice
SAN DIEGO—Top researchers gathered for a review course at the start of the 2017 ACR/ARHP Annual Meeting in November to describe new research, their own treatment strategies and new ways of thinking about an array of rheumatic diseases. Here are the highlights: Raynaud’s & Other Digit Problems When a patient walks into your clinic with…
Draft Criteria for ANCA-Associated Vasculitis Released
WASHINGTON, D.C.—Rheumatologists do not have up-to-date diagnostic and classification criteria for vasculitis, a group of diseases that involves inflammation of the blood vessels, said experts speaking at the 2016 ACR/ARHP Annual Meeting session, Classification Criteria for ANCA-Associated Vasculitis. The most recent classification criteria were published by the ACR in 1990, and since then, new disease…
Diffuse Alveolar Hemorrhage Secondary to Antineutrophil Cytoplasmic Antibody–Associated Vasculitis: Predictors of Respiratory Failure and Clinical Outcomes
A variety of immune and nonimmune pathophysiologic mechanisms causing the disruption of alveolar capillaries with bleeding into the alveolar spaces can lead to diffuse alveolar hemorrhage (DAH). Immune-mediated mechanisms can cause DAH with or without the presence of capillaritis. The antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) syndromes—granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA)—are the…
Idiopathic Lung Fibrosis—Check for ANCA
New research recommends that doctors test the sera of patients with idiopathic pulmonary fibrosis for anti-neutrophil cytoplasmic antibodies (ANCA), as well as closely monitor this population for signs of lung vasculitis…
Case Study: 66-Year-Old Man with Visual Loss, Headache, Hematuria, Chronic Sinusitis
A 66-year-old man presented to the hospital with left-sided visual loss, headache, hematuria, and symptoms of a chronic sinusitis.