Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis

ABCIC

Case Report

Dilated Cardiomyopathy as a Rare Initial Manifestation of ANCA-positive Microscopic Polyangiitis: Case Report

Karoline Gonzaga Costa et al. Maria Estefânia Bosco Otto André Felipe Lobão Fernandes Nathália de Macêdo Assunção … Mariana Ubaldo Barbosa Paiva Rosyane Luz Rufino de Lima Rita Mikelle Soares Dias

Introduction

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis constitute a group of systemic small-vessel inflammatory diseases characterized by pauci-immune necrotizing vasculitis and multisystem involvement, including granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA), and microscopic polyangiitis (MPA).^– MPA is classically associated with rapidly progressive glomerulonephritis and alveolar hemorrhage, conditions that carry high morbidity and mortality when not promptly recognized and treated.^,

In addition to predominant renal and pulmonary involvement, there is growing evidence that patients with ANCA-associated vasculitis have an increased cardiovascular risk, related not only to traditional factors but also to disease-specific mechanisms such as persistent inflammation, endothelial dysfunction, and accelerated atherosclerosis.^– Studies suggest a higher incidence of major cardiovascular events (myocardial infarction, stroke, and heart failure) compared with the general population.

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Original Article

Factors Associated With the High Prevalence of Metabolic Syndrome in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Marina Lamas Figueredo et al. Matheus Alves Amaral de Lima Alexandre Moura dos Santos Samuel Katsuyuki Shinjo

Abstract

Background:

Metabolic syndrome (MetS) remains incompletely characterized in antineutrophil cytoplasmic antibody-associated vasculitis (AAV). This study aimed to determine the prevalence of MetS in patients with AAV and to identify factors associated with its presence.

Methods:

This single-center, cross-sectional study included 62 patients with AAV (42 with granulomatosis with polyangiitis, 15 with eosinophilic granulomatosis with polyangiitis, and five with microscopic polyangiitis) who were under regular follow-up at a tertiary referral hospital. Patients were matched by age and sex with 53 controls. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Statistical significance was set at p < 0.05.

Results:

The median age of the patients was 56.1 years (interquartile range, 45.6-65.5); 53.2% were women, and 85.5% were White. The prevalence of MetS was significantly higher in the AAV group than in controls (43.5% vs 13.2%; p = 0.001). Diabetes mellitus, hypertension, and a family history of cardiovascular disease were more frequent among patients with AAV, whereas body mass index (BMI) and physical inactivity did not differ between groups. In multivariable analysis, MetS (odds ratio [OR], 4.52; 95%CI, 1.66-12.27; p = 0.003) and a family history of cardiovascular disease (OR, 3.81; 95%CI, 1.09-13.34; p < 0.05) were independently associated with AAV. Among patients with AAV, no differences were observed between those with and without MetS in terms of subtype of AAV, anthropometric measures, disease activity, family history, physical inactivity, or current treatment. In a multivariable analysis restricted to patients with AAV, MetS was independently associated with male sex (OR, 11.43; 95%CI, 2.81-46.52; p = 0.001) and higher BMI (OR, 1.13; 95%CI, 1.02-1.25; p = 0.022).

Conclusions:

MetS was highly prevalent among patients with AAV and was associated with male sex and higher BMI, contributing to an unfavorable cardiometabolic risk profile in this single-center cohort.