Abstract: FR-PO825
Nonspecific Inflammatory Markers Can Be Predictors of Disease Activity in ANCA-Associated Vasculitis
Session Information
- Glomerular Diseases: Immunology, Inflammation - I
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1202 Glomerular Diseases: Immunology and Inflammation
Authors
- Rymarz, Aleksandra, Military Institute of Medicine, Warsaw, Poland
- Mosakowska, Magdalena, Military Institute of Medicine, Warsaw, Poland
- Niemczyk, Stanislaw, Military Medical Institute of Warsaw, Warsaw, Poland
Background
The purpose of the study was to compare non-specific inflammatory markers such as high sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR) and procalcitonin level (PCT) in clinically active ANCA associated vasculitis (AAV) before and after the induction therapy.
Methods
28 patients with AAV diagnosed in the Nephrology Clinic between 2014 and 2017 were included. sCRP was measured using nephelometry assay (BNII Siemens) with a cutoff point 0.8 mg/dl and procalcitonin level using electrochemiluminescence method (Elecsys BRAHMS PCT Cobas, Roche) with the upper reference range of 0.046 ng/ml. Statistical analysis was performed using Mann-Whitney, Wilcoxon signed-rank and Kruskal-Wallis tests (SPSSv18).
Results
28 patients with a median age 58 years (67.9% female) were included. Granulomatosis with polyangitis (GPA) was diagnosed in 16 (57%) patients, microscopic polyangitis (MPA) in 13 (43%). The most frequently affected organs were: lungs (83%), joints (83%) and kidneys (75%). Before the treatment the median BVAS/WG score was 7 points, the median hsCRP was 2 mg/dl, median ESR 56 mm and the median PCT was 0.17 ng/ml. Severe, systemic disease (EULAR) was diagnosed in 12 patients (42.8%). The these cases median hsCRP (10.3mg/dl), ESR (81.6 mm) and PCT (3.4 ng/ml) were significantly higher in comparison to the rest of the study group (p=0.006,0.007, <0.001 respectively).
The mean serum creatinine concentration (SCr) was 3.4 ±2.2 mg/dl, eGFR 33.2 ±30,4 ml/min/1.7 m2, 12 patients were treated with hemodialysis. The median ANCA level was 51 IU/ml. In all patients concomitant infections were excluded.
After 6 months of treatment the whole group reached clinical remission. Median hsCRP was 0.2 mg/dl, ESR 17 mm, PCT 0.05 ng/ml and were significantly lower (p<0.001) in comparison to the levels before the treatment. The mean ANCA level was 4.5 IU/ml and were significantly lower after the induction treatment (p<0.001).
Conclusion
Non-specific inflammatory markers such as CRP, ESR, procalcitonin levels are associated with AAV activity and decreases after immunosuppressive, induction therapy.