RT Journal Article
SR Electronic
T1 Propylthiouracil-induced Antineutrophil Cytoplasmic Antibody (ANCA)-associated Renal Vasculitis Versus Primary ANCA-associated Renal Vasculitis: A Comparative Study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 558
OP 563
DO 10.3899/jrheum.110931
VO 39
IS 3
A1 YONG-XI CHEN
A1 WEN ZHANG
A1 XIAO-NONG CHEN
A1 HAI-JIN YU
A1 LI-YAN NI
A1 JING XU
A1 XIAO-XIA PAN
A1 HONG REN
A1 NAN CHEN
YR 2012
UL http://www.jrheum.org/content/39/3/558.abstract
AB Objective. Renal involvement is frequently present in primary antineutrophil cytoplasmic antibody-associated small-vessel vasculitis (AAV) as well as propylthiouracil (PTU)-induced AAV. We analyzed the characteristics of patients with PTU-induced AAV with renal involvement and investigated the differences of the 2 diseases. Methods. Thirty-six patients with PTU-induced AAV, diagnosed from 1997 to 2010, were enrolled for study. Their data were compared with those of 174 patients with primary AAV diagnosed at the same time. Renal involvement was present in all patients. Results. There was a prominent proportion of young women with PTU-induced AAV (p < 0.01). They had lower levels of proteinuria and serum creatinine and higher estimated glomerular filtration rate (p < 0.01, p < 0.01, and p < 0.01, respectively). Clinical immunological abnormalities were less severe in patients with PTU-induced AAV. Patients with PTU-induced AAV had less organ involvement and lower Birmingham Vasculitis Assessment Score than patients with primary AAV (p < 0.01). Renal biopsies showed a lower proportion of glomeruli with crescents (p < 0.01). Interstitial inflammation was less severe in patients with PTU-induced AAV (p < 0.05). Similarly, interstitial fibrosis and tubular atrophy were less severe in patients with PTU-induced AAV (p < 0.01, p < 0.05, respectively). Renal survival and total survival were better in patients with PTU-associated vasculitis (p < 0.05, p = 0.01). Conclusion. Clinical and histopathological abnormalities were less severe in patients with PTU-induced AAV and most of them had a good prognosis.