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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Am+Soc+Nephrol
2015 ; 26
(3
): 537-42
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ANCA as a predictor of relapse: useful in patients with renal involvement but not
in patients with nonrenal disease
#MMPMID25324502
Kemna MJ
; Damoiseaux J
; Austen J
; Winkens B
; Peters J
; van Paassen P
; Cohen Tervaert JW
J Am Soc Nephrol
2015[Mar]; 26
(3
): 537-42
PMID25324502
show ga
The value of measuring ANCA during follow-up to predict a relapse is
controversial. On the basis of recently obtained pathophysiologic insights, we
postulated that measuring ANCA is useful in patients with renal involvement but
is less valuable in patients with nonrenal disease. One hundred sixty-six
consecutive patients with ANCA-associated vasculitis, positive for either
proteinase 3 (PR3)-ANCA or myeloperoxidase (MPO)-ANCA, were included in our
study, followed at regular intervals, and tested for PR3-ANCA and MPO-ANCA. In
this cohort, 104 patients had renal involvement (72 with PR3-ANCA, 32 with
MPO-ANCA) and 62 patients had nonrenal disease (36 with PR3-ANCA, 26 with
MPO-ANCA). During an average (±SD) follow-up of 49±33 months and 18±14 ANCA
measurements, 89 ANCA rises and 74 relapses were recorded. ANCA rises correlated
with relapses in patients who presented with renal involvement (hazard ratio
[HR], 11.09; 95% confidence interval [95% CI], 5.01 to 24.55), but in comparison,
associated only weakly with relapses in patients who presented with nonrenal
disease (HR, 2.79; 95% CI, 1.30 to 5.98). In conclusion, longitudinal ANCA
measurements may be useful in patients with renal involvement but is less
valuable in patients with nonrenal disease.