Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis: Experience of a fourth level center

Abstract

Introduction: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis affects small vessels. There are few reports in hospitalized patients. The objective of the study was to describe the demographic, clinical-pathological characteristics, complications, relapses and outcomes.

Purpose: To describe the experience in the diagnosis, management and outcome of this pathology during 6 years.

Methodology: Retrospective cross-sectional descriptive study. Non-probability sampling for convenience developed at the Hospital Clínica San Rafael Bogotá Colombia between 2017-2022.

Results: 23 patients were included. 60.9% men with a mean age of 50 years. The main symptom was hemoptysis (21.7%). 47.6% behaved like rapidly progressive glomerulonephritis and 21.7% presented lung involvement. The positivity of pANCAS, cANCAS, ANAS, Anti MPO and AntiPR3 was 73.9%, 13%, 47.6%, 31.6% and 8.3% respectively. Biopsy was performed in 21 patients with an average of 22 glomeruli documenting 70% pauciimmune pattern. Plasma exchange was performed in 73.9% and the most widely used regimen was CYCLOPS (78.3%). No patient died. 73.9% required dialysis of which 60.9% discharged on dialysis. Renal function recovery was observed at 6 and 12 months in 21.7% and 26.1%. The relapse at one year occurred in 27.3%.

Conclusions: It is essential to know the clinical manifestations, diagnostic tests and treatment of this entity, especially because if it is carried out effectively, mortality and complications can be modified. Patients who received timely treatment presented a high percentage of renal recovery despite the severe compromise in the renal biopsy.