CLINICAL AND LABORATORY FEATURES OF ANCA ASSOCIATED VASCULITIS: EXPERIENCE AT A TERTIARY CARE HOSPITAL IN LAHORE, PAKISTAN

Muhammad Zeeshan Aslam; Asadullah kakkar; Haseeb Ahmed Khan; Saira Elaine Anwar khan

doi:10.51253/pafmj.v71i1.3157

Authors

Muhammad Zeeshan Aslam Fatima Memorial Hospital, Lahore Pakistan
Asadullah kakkar Fatima Memorial Hospital, Lahore Pakistan
Haseeb Ahmed Khan Fatima Memorial Hospital, Lahore Pakistan
Saira Elaine Anwar khan Fatima Memorial Hospital, Lahore Pakistan

DOI:

https://doi.org/10.51253/pafmj.v71i1.3157

Keywords:

Anti cytoplasmic antibody associated vasculitis, Eosinophilic granulomatosis with polyangiitis, Granulomatosis with polyangiitis, Microscopic polyangiitis

Abstract

Objective: To determine the clinical and laboratory features during the disease course in patients of anti
cytoplasmic antibody (ANCA) associated vasculitis in Pakistani patients presenting to a tertiary care center.

Study Design: Case series.

Place and Duration of Study: Fatima Memorial Hospital Shadman Lahore, from Dec 2018 to Mar 2019.

Methodology: A collection of 20 patients regarding demographic data, constitutional symptoms, mucocutaneous symptoms and signs, upper respiratory symptoms, lower respiratory symptoms, orbital and ocular manifestation, cardiovascular, peripheral vascular manifestation, central and peripheral neurologic manifestation, abdominal manifestation and renal manifestation

Results: Sixteen patients (80%) had a diagnosis of Granulomatosis with Polyangiitis, and 4 patients (20%) were
of microscopic polyangiitis. The most common systemic involvement in descending order were constitutional
symptoms (75%), ear nose and throat symptoms (50%), renal (50%), respiratory (45%), ocular (40%) and neurologic (40%). Most common laboratory abnormalities in our patients included leukocytosis (45%), anemia (35%), hematuria (50%), proteinuria (45%), and elevated serum creatinine (45%). Cytoplasmic-anti cytoplasmic antibody (C-ANCA) was positive in 11 (55%), all cases were of granulomatosis with polyangiitis, P-ANCA was positive in 5 (25%) of all patients, with 4 (100%) in Microscopic polyangiitis. Analysis of Granulomatosis with Polyangiitis according to gender and cytoplasmic-anti cytoplasmic antibody status showed correlation of renal involvement with cytoplasmic-anti cytoplasmic antibody status with statistical significance of p=0.036. Plain chest X-rays showed infiltrates in 2 (10%), nodularity 2 (10%), cavitation in 2 (10%), effusion in 1 (5%), and reticulonodular showing in 1 (5%) patients. High-resolution computed tomography findings included ground-glass opacification in 5............