CLINICAL PROFILE, TREATMENT MODALITIES AND OUTCOME IN ANCA (ANTINEUTOPHILIC CYTOPLASMIC ANTIBODY) ASSOCIATED) VASCULITIS WITH KIDNEY INVOLVEMENT- A SINGLE CENTRE EXPERIENCE FROM SOUTH INDIA

Introduction:

Due to paucity of data in developing countries on ANCA Associated Vasculitis (AAV) with Renal involvement. We are presenting our experience of treating AAV from a Tertiary care Centre in South India.

Methods:

Subsequently all patients diagnosed with AAV from 2016-2022 with at least 1 year follow up were enrolled in the study. Data was acquired from the electronic records and was analyzed using SPSS Version 21 software

Results:

Sixty six patients of AAV were enrolled, 45 (68.2%) were females. The mean (SD) age of presentation of AAV is 44.8 years (13.6). The mean GFR at presentation was 40.5(41.6).

35 patients had Myeloperoxidase (MPO)AAV, 22 had PR3 AAV with 3 patients have both positive (MPO plus PR3 positivity) and 2 were having concomitant Anti GBM disease. The mean (SD) ANCA titres at presentation in patients with PR3 AAV were 173 (87.6) and MPO AAV were 134 (69.6).

23(36.5%) and 12(19%) patients had partial remission in MPO AAV and PR3 AAV respectively. 7 (11%) and 6(9.5%) patients had complete remission in MPO AAV and PR3 AAV respectively. There was progressive kidney disease in 2(3.2%) and 2(3.2%) of MPO AAV and PR3 AAV patients respectively. 3(4.8%) patients of MPO vasculitis progressed to End Stage Kidney Disease(ESKD) and 1(1.6%) in PR3 AAV.

Remission induction treatment included Rituximab which was given in 18 (27.3%) patients and Cyclophosphamide in 44(66.7%) patients. The Remission maintenance treatment included Azathioprine given in 36(56.3%) of patients and Rituximab in 13 (20.6%) patients.

Major Relapse was seen in 3(4.5%) of MPO AAV and 6(9.1%) of PR3AAV patients over a median follow up of 475 days (IQR 109,654).

Infections were the most common adverse event seen in 29(43.9%) patients.15(22.7%) and 10(15.2%) patients had infections with cyclophosphamide and Rituximab as induction respectively. Lower respiratory tract infection seen in 14(21.2%) patients were the most common infection.

Conclusions:

In our study, AAV with renal involvement was more common in female population with MPO AAV being the commoner type having better remission rates at one year compared to PR3 AAV and also relapses were more common in PR3 vasculitis.

On comparison cyclophosphamide as Induction agent had higher infection rate than rituximab.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.