Exploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis
Abstract A novel patient cluster in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) may be identified in Japan. We performed multiple correspondence and cluster analysis regarding 427 clinically diagnosed AAV patients excluding eosinophilic granulomatosis with polyangiitis. Mo...
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Nature Portfolio
2021
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oai:doaj.org-article:47228f3b83d241069b3bd203537b1d6a2021-12-02T13:34:50ZExploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis10.1038/s41598-021-84627-62045-2322https://doaj.org/article/47228f3b83d241069b3bd203537b1d6a2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84627-6https://doaj.org/toc/2045-2322Abstract A novel patient cluster in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) may be identified in Japan. We performed multiple correspondence and cluster analysis regarding 427 clinically diagnosed AAV patients excluding eosinophilic granulomatosis with polyangiitis. Model 1 included the ANCA phenotype, items of the Birmingham Vasculitis Activity Score, and interstitial lung disease; model 2 included serum creatinine (s-Cr) and C-reactive protein (CRP) levels with model 1 components. In seven clusters determined in model 1, the ANCA-negative (n = 8) and proteinase 3-ANCA-positive (n = 41) groups emerged as two distinct clusters. The other five myeloperoxidase-ANCA-positive clusters were characterized by ear, nose, and throat (ENT) (n = 47); cutaneous (n = 36); renal (n = 256), non-renal (n = 33); and both ENT and cutaneous symptoms (n = 6). Four clusters in model 2 were characterized by myeloperoxidase-ANCA negativity (n = 42), without s-Cr elevation (< 1.3 mg/dL) (n = 157), s-Cr elevation (≥ 1.3 mg/dL) with high CRP (> 10 mg/dL) (n = 71), or s-Cr elevation (≥ 1.3 mg/dL) without high CRP (≤ 10 mg/dL) (n = 157). Overall, renal, and relapse-free survival rates were significantly different across the four clusters in model 2. ENT, cutaneous, and renal symptoms may be useful in characterization of Japanese AAV patients with myeloperoxidase-ANCA. The combination of s-Cr and CRP levels may be predictive of prognosis.Haruki WatanabeKen-ei SadaMasayoshi HarigaiKoichi AmanoHiroaki DobashiYoshinari TakasakiShouichi FujimotoTatsuya AtsumiKunihiro YamagataSakae HommaYoshihiro ArimuraHirofumi MakinoResearch Committee of Intractable Vasculitis Syndrome (JPVAS)Research Committee of Intractable Renal Disease of the Ministry of Health, Labour, and Welfare of JapanNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021) |
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Medicine R Science Q Haruki Watanabe Ken-ei Sada Masayoshi Harigai Koichi Amano Hiroaki Dobashi Yoshinari Takasaki Shouichi Fujimoto Tatsuya Atsumi Kunihiro Yamagata Sakae Homma Yoshihiro Arimura Hirofumi Makino Research Committee of Intractable Vasculitis Syndrome (JPVAS) Research Committee of Intractable Renal Disease of the Ministry of Health, Labour, and Welfare of Japan Exploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis |
| description |
Abstract A novel patient cluster in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) may be identified in Japan. We performed multiple correspondence and cluster analysis regarding 427 clinically diagnosed AAV patients excluding eosinophilic granulomatosis with polyangiitis. Model 1 included the ANCA phenotype, items of the Birmingham Vasculitis Activity Score, and interstitial lung disease; model 2 included serum creatinine (s-Cr) and C-reactive protein (CRP) levels with model 1 components. In seven clusters determined in model 1, the ANCA-negative (n = 8) and proteinase 3-ANCA-positive (n = 41) groups emerged as two distinct clusters. The other five myeloperoxidase-ANCA-positive clusters were characterized by ear, nose, and throat (ENT) (n = 47); cutaneous (n = 36); renal (n = 256), non-renal (n = 33); and both ENT and cutaneous symptoms (n = 6). Four clusters in model 2 were characterized by myeloperoxidase-ANCA negativity (n = 42), without s-Cr elevation (< 1.3 mg/dL) (n = 157), s-Cr elevation (≥ 1.3 mg/dL) with high CRP (> 10 mg/dL) (n = 71), or s-Cr elevation (≥ 1.3 mg/dL) without high CRP (≤ 10 mg/dL) (n = 157). Overall, renal, and relapse-free survival rates were significantly different across the four clusters in model 2. ENT, cutaneous, and renal symptoms may be useful in characterization of Japanese AAV patients with myeloperoxidase-ANCA. The combination of s-Cr and CRP levels may be predictive of prognosis. |
| format |
article |
| author |
Haruki Watanabe Ken-ei Sada Masayoshi Harigai Koichi Amano Hiroaki Dobashi Yoshinari Takasaki Shouichi Fujimoto Tatsuya Atsumi Kunihiro Yamagata Sakae Homma Yoshihiro Arimura Hirofumi Makino Research Committee of Intractable Vasculitis Syndrome (JPVAS) Research Committee of Intractable Renal Disease of the Ministry of Health, Labour, and Welfare of Japan |
| author_facet |
Haruki Watanabe Ken-ei Sada Masayoshi Harigai Koichi Amano Hiroaki Dobashi Yoshinari Takasaki Shouichi Fujimoto Tatsuya Atsumi Kunihiro Yamagata Sakae Homma Yoshihiro Arimura Hirofumi Makino Research Committee of Intractable Vasculitis Syndrome (JPVAS) Research Committee of Intractable Renal Disease of the Ministry of Health, Labour, and Welfare of Japan |
| author_sort |
Haruki Watanabe |
| title |
Exploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis |
| title_short |
Exploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis |
| title_full |
Exploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis |
| title_fullStr |
Exploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis |
| title_full_unstemmed |
Exploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis |
| title_sort |
exploratory classification of clinical phenotypes in japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/47228f3b83d241069b3bd203537b1d6a |
| work_keys_str_mv |
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| _version_ |
1718392731987869696 |