Giuseppe A Ramirez1, Emanuel Della-Torre2, Corrado Campochiaro2, Enrica Bozzolo3, Alvise Berti2, Luisa Praderio3, Lorenzo Dagna2, Maria Grazia Sabbadini2. 1. Vita-Salute San Raffaele University, Milan, Italy; Unit of Internal Medicine and Clinical Immunology, IRCCS-San Raffaele Scientific Institute, Ospedale San Raffaele, via Olgettina 60, 20132 Milan, Italy. Electronic address: ramirez.giuseppealvise@hsr.it. 2. Vita-Salute San Raffaele University, Milan, Italy; Unit of Internal Medicine and Clinical Immunology, IRCCS-San Raffaele Scientific Institute, Ospedale San Raffaele, via Olgettina 60, 20132 Milan, Italy. 3. Unit of Internal Medicine and Clinical Immunology, IRCCS-San Raffaele Scientific Institute, Ospedale San Raffaele, via Olgettina 60, 20132 Milan, Italy.
Abstract
OBJECTIVES: To describe the clinical, pathological, serological, and radiological characteristics of juxta-vertebral masses occurring in patients with granulomatosis with polyangiitis (GPA). METHODS: We analyzed the clinical records of patients with juxta-vertebral lesions from our GPA study cohort and reviewed the English literature for other cases of GPA with juxta-vertebral localization. RESULTS: Out of 74 patients in our GPA study cohort, six (8%) had juxta-vertebral lesions. We found 10 cases of juxta-vertebral GPA described in the English literature. Overall, juxta-vertebral lesions were detected at GPA onset in 11/16 (69%) patients, and preferentially occurred on the right side of the spine (12/15 patients, 80%). Fifteen patients (94%) with juxta-vertebral lesions had systemic GPA. Juxta-vertebral lesions were associated with back pain at GPA onset in 8/16 (50%) patients. In all of them juxta-vertebral lesions resolved or improved after treatment. CONCLUSIONS: Preference for the right-anterior side of the spine, increased 18FDG uptake on PET scan, low or absent invasiveness of the surrounding tissues, and occurrence in the context of systemic disease were the main features of juxta-vertebral GPA. Symptomatic lesions showed a better response to immunosuppressive therapies.
OBJECTIVES: To describe the clinical, pathological, serological, and radiological characteristics of juxta-vertebral masses occurring in patients with granulomatosis with polyangiitis (GPA). METHODS: We analyzed the clinical records of patients with juxta-vertebral lesions from our GPA study cohort and reviewed the English literature for other cases of GPA with juxta-vertebral localization. RESULTS: Out of 74 patients in our GPA study cohort, six (8%) had juxta-vertebral lesions. We found 10 cases of juxta-vertebral GPA described in the English literature. Overall, juxta-vertebral lesions were detected at GPA onset in 11/16 (69%) patients, and preferentially occurred on the right side of the spine (12/15 patients, 80%). Fifteen patients (94%) with juxta-vertebral lesions had systemic GPA. Juxta-vertebral lesions were associated with back pain at GPA onset in 8/16 (50%) patients. In all of them juxta-vertebral lesions resolved or improved after treatment. CONCLUSIONS: Preference for the right-anterior side of the spine, increased 18FDG uptake on PET scan, low or absent invasiveness of the surrounding tissues, and occurrence in the context of systemic disease were the main features of juxta-vertebral GPA. Symptomatic lesions showed a better response to immunosuppressive therapies.