• Revista médica de Chile · Jun 2020

    [Variables associated with mortality in 103 patients with anti-neutrophil cytoplasmic antibodies associated vasculitis].

    • Daniela Vargas, Annelise Goecke, Héctor Gatica, Ariel Castro Lara, and Pamela Wurmann.
    • Departamento de Medicina, Hospital Clínico, Universidad de Chile, Santiago, Chile.
    • Rev Med Chil. 2020 Jun 1; 148 (6): 755-761.

    BackgroundCumulative survival in patients with anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (VAA) is 88 and 78% at 1 and 5 years, respectively. Despite this, mortality continues to be 2.7 times higher than the general population. Differences in the clinical profile of VAA in different ethnicities have been observed.AimTo identify factors at the time of diagnosis, associated with mortality at one year of follow-up and to describe the clinical characteristics of these patients.Material And MethodsWe identified in local databases and reviewed clinical records of patients with VAA with at least one year of follow up in a clinical hospital. Demographic and laboratory parameters and clinical activity scores were analyzed.ResultsOf 103 patients with VAA identified, 65 met the inclusion criteria and were analyzed. Their age ranged from 45 to 63 years and 56% were women. Thirty-five patients (54%) were diagnosed as granulomatosis with Polyangiitis (GPA) and 30 patients (46%) with Microscopic Polyangiitis (MPA). The frequency of renal disease was 53% and pulmonary involvement occurred in 72%. At one year of follow-up 11 patients died resulting in a mortality of 17%. Seven patients died within three months after diagnosis. MPO ANCA were more common than PR3 ANCA. In the multivariate analysis, the presence of ophthalmological involvement, lung kidney syndrome and a Five Factor Score (FFS) of 1 or more were independent factors associated with mortality at one year.ConclusionsIn these patients, pulmonary manifestations predominate. Lung kidney syndrome, ophthalmological involvement and a FFS score ≥ 1 were associated with mortality.

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