OBJECTIVE: To determine the prevalence of lung abnormalities on chest computed tomography (CT) in patients with microscopic polyangiitis (MPA), to assess the responsiveness of such abnormalities to initial treatment, and to assess associations between these abnormalities and patient and disease characteristics and mortality. METHODS: We retrospectively identified 167 consecutive hospital-based patients with MPA in 3 hospitals in Japan. We longitudinally collected clinical information for 150 of these patients, for whom CT images obtained before treatment were available. We then determined the presence of 22 imaging components of lung abnormalities in these patients. RESULTS: The vast majority of patients (97%) had at least 1 lung abnormality on chest CT images, including interstitial lung lesions (66%), airway lesions (66%), pleural lesions (53%), and emphysematous lesions (37%). In multivariate analyses, ground-glass opacity was associated with the Birmingham Vasculitis Activity Score, whereas 3 of 4 airway lesions were associated with myeloperoxidase-antineutrophil cytoplasmic antibodies. Latent class analysis identified a distinct group of patients with airway-predominant lung lesions. Airway lesions such as bronchiolitis and bronchovascular bundle thickening were among the components that showed improvement within 3 months of the initial treatment. An idiopathic pulmonary fibrosis pattern was the only chest CT variable that was independently associated with shorter survival. CONCLUSION: Abnormalities in a wide range of anatomic areas, including the whole airway, can be identified in the lungs of patients with MPA before treatment. The prevalence, clustering patterns, and responsiveness to treatment of individual lung abnormalities provide groundwork for informing future studies to understand the pathophysiology of MPA.
OBJECTIVE: To determine the prevalence of lung abnormalities on chest computed tomography (CT) in patients with microscopic polyangiitis (MPA), to assess the responsiveness of such abnormalities to initial treatment, and to assess associations between these abnormalities and patient and disease characteristics and mortality. METHODS: We retrospectively identified 167 consecutive hospital-based patients with MPA in 3 hospitals in Japan. We longitudinally collected clinical information for 150 of these patients, for whom CT images obtained before treatment were available. We then determined the presence of 22 imaging components of lung abnormalities in these patients. RESULTS: The vast majority of patients (97%) had at least 1 lung abnormality on chest CT images, including interstitial lung lesions (66%), airway lesions (66%), pleural lesions (53%), and emphysematous lesions (37%). In multivariate analyses, ground-glass opacity was associated with the Birmingham Vasculitis Activity Score, whereas 3 of 4 airway lesions were associated with myeloperoxidase-antineutrophil cytoplasmic antibodies. Latent class analysis identified a distinct group of patients with airway-predominant lung lesions. Airway lesions such as bronchiolitis and bronchovascular bundle thickening were among the components that showed improvement within 3 months of the initial treatment. An idiopathic pulmonary fibrosis pattern was the only chest CT variable that was independently associated with shorter survival. CONCLUSION: Abnormalities in a wide range of anatomic areas, including the whole airway, can be identified in the lungs of patients with MPA before treatment. The prevalence, clustering patterns, and responsiveness to treatment of individual lung abnormalities provide groundwork for informing future studies to understand the pathophysiology of MPA.
Authors: Luis Felipe Flores-Suárez; Marco A Alba; Heidegger Mateos-Toledo; Natllely Ruiz Journal: Curr Rheumatol Rep Date: 2017-09 Impact factor: 4.592
Authors: Marco A Alba; Luis Felipe Flores-Suárez; Ashley G Henderson; Hong Xiao; Peiqi Hu; Patrick H Nachman; Ronald J Falk; J Charles Jennette Journal: Autoimmun Rev Date: 2017-05-04 Impact factor: 9.754
Authors: Giorgio Trivioli; Seerapani Gopaluni; Maria L Urban; Davide Gianfreda; Matthias A Cassia; Paolo G Vercelloni; Marta Calatroni; Alessandra Bettiol; Pasquale Esposito; Corrado Murtas; Federico Alberici; Federica Maritati; Lucio Manenti; Alessandra Palmisano; Giacomo Emmi; Paola Romagnani; Gabriella Moroni; Gina Gregorini; Renato A Sinico; David R W Jayne; Augusto Vaglio Journal: Clin Kidney J Date: 2020-09-06
Authors: Anna Stainer; Alex Rice; Anand Devaraj; Joseph Luke Barnett; Jacqueline Donovan; Maria Kokosi; Andrew Gordon Nicholson; Tom Cairns; Athol Umfrey Wells; Elisabetta Augusta Renzoni Journal: BMC Pulm Med Date: 2019-10-24 Impact factor: 3.320