scholarly journals ВАСКУЛИТЫ, АССОЦИИРОВАННЫЕ С АНТИТЕЛАМИ К ЦИТОПЛАЗМЕ НЕЙТРОФИЛОВ (АНЦА): СОСТОЯНИЕ ПРОБЛЕМЫ И КЛИНИКО-ЛАБОРАТОРНЫЕ СОПОСТАВЛЕНИЯ

2020 ◽  
pp. 58
Author(s):  
А. Э. Багрий ◽  
К. А. Ступакова ◽  
Л. И. Ткаченко ◽  
О. Е. Супрун ◽  
Е. Р. Цирковская
Keyword(s):  
Damage Index ◽  
Vasculitis Damage Index

АНЦА-ассоциированные васкулиты – это группа системных заболеваний, поражающих сосуды мелкого и, реже, среднего калибра, характеризующаяся малоизученным патогенезом, полиморфизмом клинических проявлений, агрессивностью течения, а также участием в патогенезе антинейтрофильных цитоплазматических антител. Прогноз при данной нозологической группе во многом зависит от тактики лечения и своевременности диагностики. Цель исследования: представить обзор литературы с рекомендациями по диагностике, лечению и ведению пациентов с АНЦА-ассоциированными васкулитами. Продемонстрировать особенности клиники и диагностики данной нозологической группы, полиморфизм клинических проявлений и схожесть течения гранулематоза с полиангиитом, микроскопического полиангиита и эозинофильного гранулематоза с полиангиитом. Выявить связь между тяжестью течения и профилем антинейтрофильных цитоплазматических антител.Материалы и методы: проанализированы современные отечественные и зарубежные источники литературы. Проведен ретроспективный анализ данных на основе выписных эпикризов 54 пациентов, проходивших лечение в нефрологическом и ревматологическом отделении Донецкого клинического территориального медицинского объединения за период с января 2014 по февраль 2020 года. Все пациенты были разделены на 3 группы: больные гранулематозом с полиангиитом, микроскопическим полиангиитом и эозинофильным гранулематозом с полиангиитом. Также все пациенты были разделены на подгруппы «а» (с положительным профилем АНЦА) и «б» (с отрицательным результатом). Для всех больных с целью определения степени тяжести повреждения внутренних органов был рассчитан индекс поражения внутренних органов (Vasculitis Damage Index). При оценке достоверности различий использовался непараметрический U-критерий Манна-Уитни.Результаты: полученные данные демонстрируют полиморфизм клинических проявлений и схожесть течения всех васкулитов из группы АНЦА-ассоциированных, за исключением некоторых особенностей в каждом из них. Статистический анализ, проведённый при помощи критерия Манна-Уитни, показал отсутствие достоверных отличий тяжести течения заболевания среди пациентов с различными видами АНЦА-ассоциированных васкулитов и в подгруппах пациентов с положительным и отрицательным результатом исследования профиля АНЦА.Выводы: АНЦА-ассоциированные васкулиты – сложная патология, требующая тщательной дифференциальной диагностики как между нозологиями внутри группы, так и с другими васкулитами и прочими системными заболеваниями. В связи с этим информированность врачей на всех уровнях медицинской помощи должна оставаться высокой, чтобы диагностический поиск занимал как можно меньше времени и не возникало пролонгации начала терапии. Также приведённые данные демонстрируют важность, но не категоричность роли обнаружения антинейтрофильных антител в сыворотке крови больных при диагностике данной группы васкулитов. Несмотря на данные литературы о положительной корреляционной связи между уровнем АНЦА и тяжестью течения заболевания, наш анализ не подтвердил данное утверждение. Такой результат может быть связан с недостаточным объёмом выборки, что требует дальнейших исследований в этом направлении.

scholarly journals Serum interleukin-16 significantly correlates with the Vasculitis Damage Index in antineutrophil cytoplasmic antibody-associated vasculitis

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Taejun Yoon ◽  
Jung Yoon Pyo ◽  
Sung Soo Ahn ◽  
Jason Jungsik Song ◽  
Yong-Beom Park ◽  
...  
Keyword(s):  
Damage Index ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Vasculitis Damage Index

scholarly journals Development and initial validation of the vasculitis damage index for the standardized clinical assessment of damage in the systemic vasculitides

1997 ◽  
Vol 40 (2) ◽  
pp. 371-380 ◽  
Author(s):  
A. R. Exley ◽  
P. A. Bacon ◽  
R. A. Luqmani ◽  
G. D. Kitas ◽  
C. Gordon ◽  
...  
Keyword(s):  
Clinical Assessment ◽  
Damage Index ◽  
Initial Validation ◽  
Vasculitis Damage Index

SAT0286 Paediatric Vasculitis Damage Index: A New Tool for Standardised Disease Assessment

2014 ◽  
Vol 73 (Suppl 2) ◽  
pp. 696.4-697 ◽  
Author(s):  
P. Dolezalova ◽  
N. Wilkinson ◽  
P.A. Brogan ◽  
J. Anton ◽  
S.M. Benseler ◽  
...  
Keyword(s):  
Damage Index ◽  
Disease Assessment ◽  
Vasculitis Damage Index

scholarly journals Vasculitis damage index in Behçet’s disease

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Fatema T. Elgengehy ◽  
Sherif M. Gamal ◽  
Nesreen Sobhy ◽  
Ibrahem Siam ◽  
Ahmed M. Soliman ◽  
...  
Keyword(s):  
Behçet’S Disease ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Immunosuppressive Treatment ◽  
Damage Index ◽  
Clinical Manifestations ◽  
Behcet's Disease ◽  
Vasculitis Damage Index ◽  
Relationship Of ◽  
The Relationship

Abstract Background Vasculitis damage index (VDI) is a validated damage index for systemic vasculitis, and as Behçet’s disease is considered one of systemic vascular disease we aimed to study the relationship of the vasculitis damage index to clinical manifestations and comorbidity in patients with Behçet’s disease (BD) to determine if VDI could be used to assess damage in patients with BD. Methods A total of 109 patients with BD were recruited from the Rheumatology Department (outpatient and inpatient clinic), Cairo University Hospitals. All patients were subjected to full history taking, clinical examination, and routine laboratory investigations. Disease activity was assessed by the BD current activity form, and the VDI was calculated in all patients. The relationship of the VDI to the disease clinical manifestations was studied. Mann–Whitney and Kruskal Wallis tests were used to estimate differences in quantitative variables. Spearman correlation test was used to test for correlation between quantitative variables. Results In the current study, the VDI ranged from 1 to 10, with a mean of 3.5 ± 1.8. It was significantly associated with total thrombosis (P = 0.022); total neurological manifestations (P = 0.000), especially stroke and cranial nerve affection; uveitis (P = 0.005); avascular necrosis (AVN) (P = 0.015); osteoporosis (P = 0.01); impaired vision (P < 0.0001); cataract (P < 0.0001); and diabetes (P = 0.012). Generally, immunosuppressive treatment was significantly associated with VDI (P = 0.039), especially cyclophosphamide (P < 0.0001), biological agent (P = 0.008), chlorambucil (P = 0.003), and anticoagulant (P = 0.02). VDI was also significantly correlated with age (P = 0.033), disease duration (P = 0.029), and duration of eye involvement (P = 0.003). Conclusion VDI is significantly associated with most disease parameters of BD, except for parameters such as mucocutaneous manifestations and uncomplicated venous thrombosis; however, further studies may be needed to establish BD-specific damage index.

scholarly journals AB0485 INVESTIGATION OF PERMANENT ORGAN DAMAGE IN GIANT CELL ARTERITIS: DISEASE FLARES ARE ASSOCIATED WITH INCREASED DAMAGE SCORES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1540.2-1540
Author(s):  
B. Ince ◽  
S. Artan ◽  
Y. Yalçinkaya ◽  
B. Artim-Esen ◽  
A. Gül ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vision Loss ◽  
Systemic Vasculitis ◽  
Damage Index ◽  
Organ Damage ◽  
Cardiovascular Damage ◽  
Vasculitis Damage Index

Background:Development of organ damage is a major concern in patients with systemic vasculitis. Treatment may also contribute to this important outcome. Scoring systems has been developed to evaluate organ damage in systemic vasculitis and specifically for large vessel vasculitis (1).Objectives:We aimed to investigate permanent organ damage and determining factors in our giant cell arteritis GCA cohort.Methods:Organ damage detected at the time of diagnosis and / or follow-up and irreversible for at least 3 months in GCA patients followed up between 1998-2018 were recorded by using Vasculitis Damage Index (VDI) and Vascular Vasculitis Damage Index (LVVID) fom patient records of our vasculitis clinic. In the statistical evaluation, chi-square, students t-test and logistic regression analysis were used.Results:Eighty-nine patients (64% women, mean age 67.9 ± 9.1) included in the study, the mean follow-up duration was 61.6 ± 58.6 months. All organ damage findings according to both VDI and LVVID are shown in table-1. In this cohort, cardiovascular damage items and diabetes mellitus were prevalent at baseline. At least one damage item was present in 53 (59,5%) according to VDI; 54 (%60,7) according to LVVID and agreement was high between two damage indices (kappa=0.97). Forty-seven of patients (52%) had a damage item presumably with contribution of GC treatment e.g. locomotor system findings, hypertension, diabetes and cataract; 12 (13,5%) had damage items related to disease (total or partial vision loss, ischemic optical neuropathy). Mean time to diagnosis after initial symptoms was longer in patients with permanent vision loss (10,2±4,3 vs. 5,2±1,2 months p=0.006). The presence of damage was associated with flares in univariate and multivariate analysis (29/54 vs. 2/35 p<0,001 OR=19 %95 GA 4,2– 87,9). All patients who had a flare during the first year (n = 15) developed signs of damage at follow-up. No association was found between the development of organ damage and the age of diagnosis, the time between first complaint and diagnosis, presence of cranial, ophthalmologic findings, PET-CT positivity, cumulative steroid dose, and DMARD use.Conclusion:In our study, permanent organ damage was analysed by using diffrerent indices. In this patient population baseline cardiovascular damage and diabetes mellitus were frequent as expected but information for osteoporosis was lacking. More than half of the patients had damage and significant part of the present items was considered due to corticosteroid treatment. The most common damage item developed was osteoporosis. There was a very good agreement between the two indices, despite few specific items in LVVID. The striking relationship of disease flare with damage and frequency of visual problems despite treatment indicate the necessity of new treatment strategies.References:[1]Kermani, T.A., et al.,Evaluation of damage in giant cell arteritis.Rheumatology (Oxford), 2018.57(2): p. 322-328.Disclosure of Interests: :None declared

scholarly journals Vasculitis Damage Index and C-Reactive Protein As Main Predictors Of Infection In Admitted Systemic Vasculitis Patients

2021 ◽  
Author(s):  
Luma Mendes Brito ◽  
Rodrigo da Silveira Vasconcelos ◽  
Felipe Mendonça de Santana ◽  
CARLOS EMILIO INSFRAN ECHAURI ◽  
Lorenza Rosa Silvério Scomparin ◽  
...  
Keyword(s):  
Systemic Vasculitis ◽  
Damage Index ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Vasculitis Damage Index

scholarly journals Damage in the anca-associated vasculitides: long-term data from the European Vasculitis Study group (EUVAS) therapeutic trials

2013 ◽  
Vol 74 (1) ◽  
pp. 177-184 ◽  
Author(s):  
Joanna Robson ◽  
Helen Doll ◽  
Ravi Suppiah ◽  
Oliver Flossmann ◽  
Lorraine Harper ◽  
...  
Keyword(s):  
A Priori ◽  
Damage Index ◽  
Study Group ◽  
Therapeutic Trials ◽  
Long Term Follow Up ◽  
Frequent Items ◽  
Vasculitis Damage Index ◽  
Over Time

ObjectivesTo describe short-term (up to 12 months) and long-term (up to 7 years) damage in patients with newly diagnosed antineutrophil-cytoplasm antibody-associated vasculitis (AAV).MethodsData were combined from six European Vasculitis Study group trials (n=735). Long-term follow-up (LTFU) data available for patients from four trials (n=535). Damage accrued was quantified by the Vasculitis Damage Index (VDI). Sixteen damage items were defined a priori as being potentially treatment-related.ResultsVDI data were available for 629 of 735 patients (85.6%) at baseline, at which time 217/629 (34.5%) had ≥1 item of damage and 32 (5.1%) ≥5 items, reflecting disease manifestations prior to diagnosis and trial enrolment. LTFU data were available for 467/535 (87.3%) at a mean of 7.3 years postdiagnosis. 302/535 patients (56.4%) had VDI data at LTFU, with 104/302 (34.4%) having ≥5 items and only 24 (7.9%) no items of damage. At 6 months and LTFU, the most frequent items were proteinuria, impaired glomerular filtration rate, hypertension, nasal crusting, hearing loss and peripheral neuropathy. The frequency of damage, including potentially treatment-related damage, rose over time (p<0.01). At LTFU, the most commonly reported items of treatment-related damage were hypertension (41.5%; 95% CI 35.6 to 47.4%), osteoporosis (14.1%; 9.9 to 18.2%), malignancy (12.6%; 8.6 to 16.6%), and diabetes (10.4%; 6.7 to 14.0%).ConclusionsIn AAV, renal, otolaryngological and treatment-related (cardiovascular, disease, diabetes, osteoporosis and malignancy) damage increases over time, with around one-third of patients having ≥5 items of damage at a mean of 7 years postdiagnosis.

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