Clinical value of antineutrophil cytoplasmic antibody in eosinophilic granulomatosis with polyangiitis / 中华风湿病学杂志

ABSTRACT

Objective To investigate the value of antineutrophil cytoplasmic antibody (ANCA) in clinical phenotype of eosinophilic granulomatosis with polyangiitis (EGPA).Methods The clinical data of 64 patients with EGPA from Peking Union Medical College Hospital between 2007 to 2016 were retrospectively analyzed,and the patients were followed up.Characteristics of patients with ANCA positive and ANCA negative were compared by independent-samples t test,Mann-Whitney U test and Chi-square test.Results Among 64 patients with EGPA,12(19％) were serum ANCA positive and 52(81％) were negative.The incidence of fever (77％ vs 35％,x2=9.403,P=0.002) and renal involvement,including proteinuria (67％ vs 25％,x2=7.678,P=0.006),hematuria (58％ vs 8％,x2=17.57,P＜0.01),renal inadequacy (33％ vs 4％,x2=9.978,P=0.002),and the BVAS score higher than 15 (92％ vs 60％,x2=4.440,P=0.035) in ANCA positive group were higher than ANCA negative group,while the presence of allergic rhinitis (17％ vs 56％,x2=5.969,P=0.015),mucocutaneous lesion (33％ vs 65％,x2=4.152,P=0.042) and cardiac involvement (8％ vs 44％,x2=3.361,P=0.021) in the ANCA-positive group was lower when compared with ANCA-negative patients.The positive ratio of rheumatoid factor (RF) (100％ vs 42％,x2=7.723,P=0.006),and the level of erythrocyte sedimentation rate (ESR) (50 vs 35.5 mm/1 h,P=0.034) in ANCA-positive group were higher than in ANCA negative group.There was no significant difference in pathological characteristics between the two groups.According to the treatment and prognosis,there were no significant differences between the two groups in the usage and dosage of steroids and immunosuppressant,the remission rate and recurrence rate of the disease,and the death rate due to the primary disease.Conclusion The clinical manifestations of EGPA are complicate.Whether ANCA is positive or not may be related to the clinical phenotypes.More attention should be paid to renal involvement in ANCA positive patients while cardiac involvement in ANCA negative patients.