ANCA-Associated Vasculitis Clinical Presentation and Clinical Predictors of Relapse in Saudi Arabia

Figures & data

Table 1 Patients Demographic Information

Variable		Value
Gender
Female	29	60.42
Male	19	39.58
Age Y		48.80435
Marital status
Married	37	82.22
Not married	8	17.78
Diagnosis
GPA	30	62.50
EGPA	12	25.00
MPA	6	12.50
Disease Duration in months		38,925.59
BVAS score at DX
14.5 or less	27	56.3
More than 14.5	21	43.8
Comorbidities:
Diabetic	13	29.55
Hypertensive	18	41.86
Dyslipidemia	9	20.45
Hypothyroidism	6	13.95
Malignancy	4	9.30
Chronic kidney disease	4	9.52
Cardiac involvement	8	19.05
Upper respiratory involvement	18	41.86
Lower respiratory involvement	32	76.19
Renal involvement	21	50.00
Joint involvement	13	31.71
Skin involvement	10	24.39
Eye involvement	9	21.95
Sinusitis	2	4.65
CNS involvement	8	19.51
Constitutional symptoms	8	19.51
WBC		12.31±6.86
HGB		10.4±2.6
PLTS		539.58±671.54
CREAT		193.84±225.13
ESR		72.61±40.07
CRP		82.29±68.93
Anti-PR3/Anti MPO	33	91.67
Anti-PR3	19	39.6
Anti-MPO	14	29.2
Anti-GBM antibody	2	4.2
C3
Normal	15	31.3
low	3	6.3
C4
Normal	17	35.4
Low	1	2.1
Rheumatoid factor
Positive	7	14.6
Negative	23	47.9
WBC above 5 cells in urine	14	29.2
RBC above 5 cells in urine	22	45.8
Quantification of 24-hour urine protein
> 500 mL	14	29.
< 500 mL	14	29.2
Abnormal Findings in high resolution CT, HRCT	31	64.6
Opacity or consolidation on chest CT	18	37.5
Granuloma/ nodules	12	25
Pleural effusion	6	12.5
Cavitation	4	8.3
Hilar lymphadenopathy	2	4.2
Bronchoscopy findings
Pulmonary hemorrhage	7	14.6
Eosinophilia> 10%	1	2.1
Evidence of Vasculitis by biopsy
Kidney	11	23
Lung	4	8
Skin	3	6
Disease Relapse
Yes	15	31.25
No	33	68.75
Number of Relapses
No relapse	33	68.75
One relapse	11	22.92
Two relapses	2	4.17
Three relapses	1	2.08
Four relapses	1	2.08
Induction Medications
CYC IV	15	34.88
RTX	14	32.56
Pulse GC	22	45.83%
GC 1 mg/day	26	54.17%
MTX	5	10.42%
MMF	3	6.25%
PLEX	11	22.92%
IVIG	3	6.25%

Figure 1 Disease or therapy related complications.

Table 2 Correlation Between BVAS at the Time of Diagnosis and Relapses

2a. Univariate Logistic Regression Analysis
Independent Variable		Odds Ratio	95% CI for OR		P-value
			Lower	Upper
BVAS score at DX More than 14.5 vs 14.5 or less		0.323	0.059	1.765	0.1922
2b. Chi-Square Test
		BVAS Score			P-value
		Less than or equal to 14.5		More than 14.5	0.366
Relapses	Yes	37.0%		63.0%
	No	23.8%		76.2%

Table 3 Correlation Between Serology Autoimmune Markers Positivity and Disease Relapse

3a. Correlation Between RF and AAV Relapse, Chi-Square Test.
			Rheumatoid Factor				P-value
			Positive	Negative	Not done
Relapses		Yes	20.0%	66.7%	13.3%		0.066
		No	12.1%	39.4%	48.5%
3b. Correlation Between ANCA and AAV Relapse, Chi-Square Test.
		ANCA Result					P-value
		Anti-PR3+	Anti-MPO+	Both negative	Not done
Relapses	Yes	31.6%	50.0%	33.3%	25.0%		0.681
	No	68.4%	50.0%	66.7%	75.0%
3c. Correlation Between Complements Revels and AAV Relapse, Chi-Square Test.
		Complement C3		P-value	Complement C4		P-value
		Low	Normal		Low	Normal
Relapses	Yes	33.3%	40.0%	0.659	0.0%	41.2%	0.466
	No	66.7%	60.0%		100.0%	58.8%

Table 4 Correlation Between Cumulative Steroid Dose Over the First Six Months and Its Relationship with Serious Infections

		Cumulative Steroid Dose		P-value
		Dose < 3095 mg	Dose > 3095
Infection	Yes	16.7%	47.1%	0.053
	No	83.3%	52.9%