Title:Comparison of Granulomatosis with Polyangiitis Clinical Features in Patients Depending on Involvement or Absence of Kidney Involvement

VOLUME: 17 ISSUE: 4

Author(s):Mateusz Puchala , Andrzej Rydzewski, Ilona Kowalik and Małgorzata Wisłowska*

Affiliation:Rheumatology and Internal Disease Department, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, 2Nephrology, Transplantology and Internal Disease Department, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, National Institute of Cardiology, Warsaw, Rheumatology and Internal Disease Department, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw

Keywords:Granulomatosis with polyangiitis, cyclophosphamide, rituximab, kidney involvement, c-ANCA, BVAS, induction therapy, maintenance therapy.

Abstract:

Background: GPA is necrotizing inflammation of the small vessels with granulomas. Kidney involvement deteriorated its prognosis.

Objective: Comparison of GPA patients with Kidney (KI) and without Kidney Involvement (nKI).

Materials and Methods: We conducted a cross-sectional study of 50 consecutive adult GPA patients, 25 KI from Nephrology and 25 nKI from the Rheumatology Department of Central Clinical Hospital Ministry of Interior in Warsaw. We analyzed clinical features, organ involvement, laboratory, serological, imaging, histopathological data, BVAS and treatment.

Results: The mean age of KI patients was statistically older than nKI (67.3±9.5 vs. 55.1±15.9, p=0.002). Generalized, severe, disease resistance was observed respectively in 92% vs. 44%, p Conclusion: In patients with KI we found generalized, severe, resistant GPA, higher BVAS more frequently than inpatients without KI. The results of laboratory parameters were worse in patients with KI. Aggressive immunosuppressive treatment is often used in the KI group.