Manifestaciones clínicas de la granulomatosis de Wegener y la poliangeítis microscópica en Santiago-Chile, 1990-2001

Background: Systemic vasculitis are a group of heterogeneous diseases characterized by inflammation and necrosis of blood vessel walls. The etiology is not known, but geographic and environmental factors are implicated. Aim: To describe the clinical features of microscopic polyangiitis (MPA) and Weg...

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Autores principales: Cisternas M,Marcela, Soto S,Lilian, Jacobelli G,Sergio, Marinovic M,María Angélica, Vargas B,Alex, Sobarzo V,Elizabeth, Saavedra M,Jorge, Chauan I,Karina, Meléndez T,Gabriela, Foster B,Carolina, Pacheco R,Daniel, Wainstein G,Eduardo
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2005
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spelling oai:scielo:S0034-988720050003000012005-05-17Manifestaciones clínicas de la granulomatosis de Wegener y la poliangeítis microscópica en Santiago-Chile, 1990-2001Cisternas M,MarcelaSoto S,LilianJacobelli G,SergioMarinovic M,María AngélicaVargas B,AlexSobarzo V,ElizabethSaavedra M,JorgeChauan I,KarinaMeléndez T,GabrielaFoster B,CarolinaPacheco R,DanielWainstein G,Eduardo Antibodies, antineutrophil cytoplasmic Vasculitis Wegener granulomatosis Background: Systemic vasculitis are a group of heterogeneous diseases characterized by inflammation and necrosis of blood vessel walls. The etiology is not known, but geographic and environmental factors are implicated. Aim: To describe the clinical features of microscopic polyangiitis (MPA) and Wegener's granulomatosis (WG) in a Chilean cohort of patients. Patients and methods: Retrospective review of the medical records of 123 patients with the diagnosis of systemic vasculitis (65 MPA and 58 WG), seen from 1990 to 2001. The diagnosis were made based on the American College of Rheumatology and Chapel Hill criteria. Results: The mean follow-up for MPA was 15 months (1-120) and for WG, 20 months (1-120). The median age (years) at diagnosis for MPA was 61 (19-82) and WG 50 (20-82). Gender distribution was similar in both groups (male: 68% and 57% respectively).The main clinical features in the MPA group were renal involvement (68%), peripheral nervous system involvement (57%), pulmonary hemorrhage (28%), and skin disease (32%). In the WG group were alveolar hemorrhage (62%), renal involvement (78%), paranasal sinus involvement (57%), and ocular disease (26%). In both, creatinine levels above 2.0 mg/dl were associated with a higher mortality (p< 0.01). ANCA by immunofluorescence was performed in 56 MPA patients (75% had pANCA, 4% had cANCA and 21% were ANCA negative) and in 55 WG patients (17% had pANCA, 79% had cANCA and 4% were ANCA negative). Global mortality was 18% and 17% respectively, and the most common causes of death were infections. Conclusions: The clinical features of our patients are similar to other published data. In our WG and MPA patients the main predictor for death was a serum creatinine above 2 mg/dl. (Rev Méd Chile 2005; 133: 273-8)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.133 n.3 20052005-03-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000300001es10.4067/S0034-98872005000300001
institution Scielo Chile
collection Scielo Chile
language Spanish / Castilian
topic Antibodies, antineutrophil cytoplasmic
Vasculitis
Wegener granulomatosis
spellingShingle Antibodies, antineutrophil cytoplasmic
Vasculitis
Wegener granulomatosis
Cisternas M,Marcela
Soto S,Lilian
Jacobelli G,Sergio
Marinovic M,María Angélica
Vargas B,Alex
Sobarzo V,Elizabeth
Saavedra M,Jorge
Chauan I,Karina
Meléndez T,Gabriela
Foster B,Carolina
Pacheco R,Daniel
Wainstein G,Eduardo
Manifestaciones clínicas de la granulomatosis de Wegener y la poliangeítis microscópica en Santiago-Chile, 1990-2001
description Background: Systemic vasculitis are a group of heterogeneous diseases characterized by inflammation and necrosis of blood vessel walls. The etiology is not known, but geographic and environmental factors are implicated. Aim: To describe the clinical features of microscopic polyangiitis (MPA) and Wegener's granulomatosis (WG) in a Chilean cohort of patients. Patients and methods: Retrospective review of the medical records of 123 patients with the diagnosis of systemic vasculitis (65 MPA and 58 WG), seen from 1990 to 2001. The diagnosis were made based on the American College of Rheumatology and Chapel Hill criteria. Results: The mean follow-up for MPA was 15 months (1-120) and for WG, 20 months (1-120). The median age (years) at diagnosis for MPA was 61 (19-82) and WG 50 (20-82). Gender distribution was similar in both groups (male: 68% and 57% respectively).The main clinical features in the MPA group were renal involvement (68%), peripheral nervous system involvement (57%), pulmonary hemorrhage (28%), and skin disease (32%). In the WG group were alveolar hemorrhage (62%), renal involvement (78%), paranasal sinus involvement (57%), and ocular disease (26%). In both, creatinine levels above 2.0 mg/dl were associated with a higher mortality (p< 0.01). ANCA by immunofluorescence was performed in 56 MPA patients (75% had pANCA, 4% had cANCA and 21% were ANCA negative) and in 55 WG patients (17% had pANCA, 79% had cANCA and 4% were ANCA negative). Global mortality was 18% and 17% respectively, and the most common causes of death were infections. Conclusions: The clinical features of our patients are similar to other published data. In our WG and MPA patients the main predictor for death was a serum creatinine above 2 mg/dl. (Rev Méd Chile 2005; 133: 273-8)
author Cisternas M,Marcela
Soto S,Lilian
Jacobelli G,Sergio
Marinovic M,María Angélica
Vargas B,Alex
Sobarzo V,Elizabeth
Saavedra M,Jorge
Chauan I,Karina
Meléndez T,Gabriela
Foster B,Carolina
Pacheco R,Daniel
Wainstein G,Eduardo
author_facet Cisternas M,Marcela
Soto S,Lilian
Jacobelli G,Sergio
Marinovic M,María Angélica
Vargas B,Alex
Sobarzo V,Elizabeth
Saavedra M,Jorge
Chauan I,Karina
Meléndez T,Gabriela
Foster B,Carolina
Pacheco R,Daniel
Wainstein G,Eduardo
author_sort Cisternas M,Marcela
title Manifestaciones clínicas de la granulomatosis de Wegener y la poliangeítis microscópica en Santiago-Chile, 1990-2001
title_short Manifestaciones clínicas de la granulomatosis de Wegener y la poliangeítis microscópica en Santiago-Chile, 1990-2001
title_full Manifestaciones clínicas de la granulomatosis de Wegener y la poliangeítis microscópica en Santiago-Chile, 1990-2001
title_fullStr Manifestaciones clínicas de la granulomatosis de Wegener y la poliangeítis microscópica en Santiago-Chile, 1990-2001
title_full_unstemmed Manifestaciones clínicas de la granulomatosis de Wegener y la poliangeítis microscópica en Santiago-Chile, 1990-2001
title_sort manifestaciones clínicas de la granulomatosis de wegener y la poliangeítis microscópica en santiago-chile, 1990-2001
publisher Sociedad Médica de Santiago
publishDate 2005
url http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000300001
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