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Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are disorders characterized by necrotizing inflammation of small sized vessels. The starring character is the neutrophil who triggers an immune response influenced by genetics and environmental factors. AAV is an uncommon disease, most information is based on European and North American population. There is spare information about epidemiologic characteristics of AAV in Latin America, however the multiethnicity, geographic diversity, low-income condition and use of toxic agents in agriculture and mining, may be factors that impact on clinical phenotype.
A cross-sectional study of an observational, analytical and retrospective cohort was carried out between 2015 and 2022 in hospitalized patients of Hospital Universitario de la Samaritana with AAV diagnosis. After ethical committee approval with data protection policy, data were obtained from Medical records. Variables were demographics (table 1); Clinical; Serological and Histopathology(Table 2). Birmingham Vasculitis Activity score (BVAS) was applied. Were evaluated a descriptive component by frequencies, and analytic component by using bivariate analysis.
We found 40 patients; 55% men, age between 21 and 76, 73% become from rural area. The entire population was classified by de Colombia socioeconomic stratification, 66.7% had a monthly income <100 dollars. 82,5% had renal impairment: 24 Acute Kidney Injury (AKI) ;16 required dialysis;60% hematuria; 93.9% proteinuria. 4 patients presented Pulmonary-renal syndrome, 8 renal biopsies with pauci-immune vasculitis. Interstitial infiltrates were the most common finding followed by Alveolar hemorrhage in lung. The most frequent phenotype was Microscopic polyangiitis. BVAS score had no statistical relation with ANCAs value, age, or clinical phenotype. Men had higher BVAS scores (p 0,024). 50% had ANAS with significant titles. Most of lowest income population presented p-ANCA (79%). 39.5% received steroids, 36.8% Cyclophosphamide (CYC) and steroids. Steroids and CYC was the preferred treatment for renal, pulmonary and neurological impairment. Infections (59%) were found as a steroid and CYC complication. Severe adverse effects were: Hemorrhagic manifestations, Aplastic anemia (1) and death (1).