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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Autores principales: 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
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Publicado: Nature Portfolio 2021
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Acceso en línea:https://doaj.org/article/47228f3b83d241069b3bd203537b1d6a
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spelling 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)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle 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
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