Peripheral neuropathy in antineutrophil cytoplasmic antibody-associated vasculitides: Insights from the DCVAS study.
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Bischof A
From the Immunology Clinic and Department of Neurology (A.B.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel; Department of Rheumatology (V.K.J., T.D.), University Hospital Basel, Switzerland; Department of Neurology (R.D.M.H.), King's College Hospital, London; Nuffield Department of Orthopedics (R.A.L., A.C.), Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, United Kingdom; Department of Neurology (A.-K.P.), University Hospital Basel & Clinical Neuroimmunology; Department of Biomedicine (A.-K.P.), University of Basel, Switzerland; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics (P.A.M.), University of Pennsylvania, Philadelphia; Department of Rheumatology (R.S.), Auckland District Health Board, New Zealand; and Department of Neurology (M.P.C.), Medical College of Wisconsin, Milwaukee, WI. Antje.Bischof@usb.ch.
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Jaeger VK
From the Immunology Clinic and Department of Neurology (A.B.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel; Department of Rheumatology (V.K.J., T.D.), University Hospital Basel, Switzerland; Department of Neurology (R.D.M.H.), King's College Hospital, London; Nuffield Department of Orthopedics (R.A.L., A.C.), Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, United Kingdom; Department of Neurology (A.-K.P.), University Hospital Basel & Clinical Neuroimmunology; Department of Biomedicine (A.-K.P.), University of Basel, Switzerland; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics (P.A.M.), University of Pennsylvania, Philadelphia; Department of Rheumatology (R.S.), Auckland District Health Board, New Zealand; and Department of Neurology (M.P.C.), Medical College of Wisconsin, Milwaukee, WI.
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Hadden RDM
From the Immunology Clinic and Department of Neurology (A.B.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel; Department of Rheumatology (V.K.J., T.D.), University Hospital Basel, Switzerland; Department of Neurology (R.D.M.H.), King's College Hospital, London; Nuffield Department of Orthopedics (R.A.L., A.C.), Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, United Kingdom; Department of Neurology (A.-K.P.), University Hospital Basel & Clinical Neuroimmunology; Department of Biomedicine (A.-K.P.), University of Basel, Switzerland; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics (P.A.M.), University of Pennsylvania, Philadelphia; Department of Rheumatology (R.S.), Auckland District Health Board, New Zealand; and Department of Neurology (M.P.C.), Medical College of Wisconsin, Milwaukee, WI.
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Luqmani RA
From the Immunology Clinic and Department of Neurology (A.B.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel; Department of Rheumatology (V.K.J., T.D.), University Hospital Basel, Switzerland; Department of Neurology (R.D.M.H.), King's College Hospital, London; Nuffield Department of Orthopedics (R.A.L., A.C.), Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, United Kingdom; Department of Neurology (A.-K.P.), University Hospital Basel & Clinical Neuroimmunology; Department of Biomedicine (A.-K.P.), University of Basel, Switzerland; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics (P.A.M.), University of Pennsylvania, Philadelphia; Department of Rheumatology (R.S.), Auckland District Health Board, New Zealand; and Department of Neurology (M.P.C.), Medical College of Wisconsin, Milwaukee, WI.
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Pröbstel AK
From the Immunology Clinic and Department of Neurology (A.B.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel; Department of Rheumatology (V.K.J., T.D.), University Hospital Basel, Switzerland; Department of Neurology (R.D.M.H.), King's College Hospital, London; Nuffield Department of Orthopedics (R.A.L., A.C.), Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, United Kingdom; Department of Neurology (A.-K.P.), University Hospital Basel & Clinical Neuroimmunology; Department of Biomedicine (A.-K.P.), University of Basel, Switzerland; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics (P.A.M.), University of Pennsylvania, Philadelphia; Department of Rheumatology (R.S.), Auckland District Health Board, New Zealand; and Department of Neurology (M.P.C.), Medical College of Wisconsin, Milwaukee, WI.
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Merkel PA
From the Immunology Clinic and Department of Neurology (A.B.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel; Department of Rheumatology (V.K.J., T.D.), University Hospital Basel, Switzerland; Department of Neurology (R.D.M.H.), King's College Hospital, London; Nuffield Department of Orthopedics (R.A.L., A.C.), Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, United Kingdom; Department of Neurology (A.-K.P.), University Hospital Basel & Clinical Neuroimmunology; Department of Biomedicine (A.-K.P.), University of Basel, Switzerland; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics (P.A.M.), University of Pennsylvania, Philadelphia; Department of Rheumatology (R.S.), Auckland District Health Board, New Zealand; and Department of Neurology (M.P.C.), Medical College of Wisconsin, Milwaukee, WI.
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Suppiah R
From the Immunology Clinic and Department of Neurology (A.B.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel; Department of Rheumatology (V.K.J., T.D.), University Hospital Basel, Switzerland; Department of Neurology (R.D.M.H.), King's College Hospital, London; Nuffield Department of Orthopedics (R.A.L., A.C.), Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, United Kingdom; Department of Neurology (A.-K.P.), University Hospital Basel & Clinical Neuroimmunology; Department of Biomedicine (A.-K.P.), University of Basel, Switzerland; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics (P.A.M.), University of Pennsylvania, Philadelphia; Department of Rheumatology (R.S.), Auckland District Health Board, New Zealand; and Department of Neurology (M.P.C.), Medical College of Wisconsin, Milwaukee, WI.
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Craven A
From the Immunology Clinic and Department of Neurology (A.B.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel; Department of Rheumatology (V.K.J., T.D.), University Hospital Basel, Switzerland; Department of Neurology (R.D.M.H.), King's College Hospital, London; Nuffield Department of Orthopedics (R.A.L., A.C.), Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, United Kingdom; Department of Neurology (A.-K.P.), University Hospital Basel & Clinical Neuroimmunology; Department of Biomedicine (A.-K.P.), University of Basel, Switzerland; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics (P.A.M.), University of Pennsylvania, Philadelphia; Department of Rheumatology (R.S.), Auckland District Health Board, New Zealand; and Department of Neurology (M.P.C.), Medical College of Wisconsin, Milwaukee, WI.
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Collins MP
From the Immunology Clinic and Department of Neurology (A.B.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel; Department of Rheumatology (V.K.J., T.D.), University Hospital Basel, Switzerland; Department of Neurology (R.D.M.H.), King's College Hospital, London; Nuffield Department of Orthopedics (R.A.L., A.C.), Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, United Kingdom; Department of Neurology (A.-K.P.), University Hospital Basel & Clinical Neuroimmunology; Department of Biomedicine (A.-K.P.), University of Basel, Switzerland; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics (P.A.M.), University of Pennsylvania, Philadelphia; Department of Rheumatology (R.S.), Auckland District Health Board, New Zealand; and Department of Neurology (M.P.C.), Medical College of Wisconsin, Milwaukee, WI.
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Daikeler T
From the Immunology Clinic and Department of Neurology (A.B.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel; Department of Rheumatology (V.K.J., T.D.), University Hospital Basel, Switzerland; Department of Neurology (R.D.M.H.), King's College Hospital, London; Nuffield Department of Orthopedics (R.A.L., A.C.), Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, United Kingdom; Department of Neurology (A.-K.P.), University Hospital Basel & Clinical Neuroimmunology; Department of Biomedicine (A.-K.P.), University of Basel, Switzerland; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics (P.A.M.), University of Pennsylvania, Philadelphia; Department of Rheumatology (R.S.), Auckland District Health Board, New Zealand; and Department of Neurology (M.P.C.), Medical College of Wisconsin, Milwaukee, WI.
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Published in:
- Neurology(R) neuroimmunology & neuroinflammation. - 2019
English
OBJECTIVE
Reported prevalence of vasculitic neuropathy (VN) in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is highly variable, and associations with other organ manifestations have not been studied systematically while accounting for diagnostic certainty of VN.
METHODS
Data of all patients with AAV within the Diagnostic and Classification criteria for primary systemic VASculitis study were analyzed cross-sectionally. VN was categorized as definite (histology proven), probable (multiple mononeuropathy or nerve biopsy consistent with vasculitis), or possible (all others). Associations with other organ manifestations were compared in patients with and without VN.
RESULTS
Nine hundred fifty-five patients (mean age 57 years, range 18-91 years, 51% female) were identified. Of these, 572 had granulomatosis with polyangiitis (GPA), 218 microscopic polyangiitis (MPA), and 165 eosinophilic granulomatosis with polyangiitis (EGPA). The prevalence of VN was 65% in EGPA, 23% in MPA, and 19% in GPA. Nerve biopsy was performed in 32/269 (12%) patients, demonstrating definite vasculitis in 17/32 (53%) of patients. VN was associated with myeloperoxidase-ANCA positivity (p = 0.004) and skin (p < 0.001), musculoskeletal, (p < 0.001) and cardiovascular (p = 0.005) involvement. Patients with VN were less likely to have renal (p < 0.001), eye (p < 0.001), and gastrointestinal (p = 0.023) involvement.
CONCLUSIONS
Our study provides comprehensive insights into the prevalence and organ associations of VN in a large, systematically collected AAV cohort. VN is most commonly associated with skin, musculoskeletal, and cardiovascular manifestations. In routine clinical practice, diagnosis of VN is infrequently confirmed by the gold standard of nerve biopsy but rather supported by the clinical setting of active systemic AAV.
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Language
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Open access status
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gold
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Identifiers
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Persistent URL
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https://sonar.ch/global/documents/138993
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