PMID- 22640651 OWN - NLM STAT- MEDLINE DCOM- 20120813 LR - 20170112 IS - 0392-856X (Print) IS - 0392-856X (Linking) VI - 30 IP - 1 Suppl 70 DP - 2012 Jan-Feb TI - Alveolar haemorrhage in ANCA-associated vasculitides: 80 patients' features and prognostic factors. PG - S77-82 AB - OBJECTIVES: Alveolar haemorrhage (AH) can be a mild or life-threatening manifestation of antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV), but its prognostic impact and specific characteristics remain controversial. Our objective was to determine the prognostic value of AH in this context. METHODS: AH episodes that occurred, between 1991 and 2010, in AAV patients entered in the FVSG database were retrospectively analysed. Data on AH characteristics and outcome measures were collected on a specific form. RESULTS: Among the 80 cases analysed, AAV were 61.25% granulomatosis with polyangiitis (GPA) (Wegener), 26.25% microscopic polyangiitis (MPA), 10% Churg-Strauss syndrome and 2 (2.5%) unclassified. Mild or severe haemoptysis alone, or together with other clinical symptoms was present in 77 (96.2%) patients before AAV diagnosis. Among 10 (12.5%) patients requiring mechanical ventilation, 4 had prior minor haemoptysis before abundant AH. Sixty-one (76.3%) patients had concomitant active rapid crescentic glomerulonephritis causing renal insufficiency (pulmo-renal syndrome): 37/49 GPA (Wegener) (75.5% of all GPA (Wegener)), 19/21 MPA (90.4% of all MPA), 3/8 had CSS and 2/2 had unclassified vasculitis. The mean AH-to-treatment-onset interval was 5.9 days. Mean follow-up was 7.3 years. Forty-seven (58.8%) patients relapsed: 23 with AH and with (13) or without (10) other organ involvement, 24 with non-AH manifestation(s). Three patients underwent kidney transplantation. Sixteen (20%, 8 GPA (Wegener) and 8 MPA) patients died. No death resulted directly from the initial AH; 14 (87.5%) patients with pulmo-renal syndrome died. CONCLUSIONS: As previously demonstrated by the Five-Factor Score, AH alone is not predictive of poor prognosis, unlike kidney involvement, which dictates a poor outcome. FAU - Kostianovsky, Alex AU - Kostianovsky A AD - Department of Internal Medicine, Hopital Cochin, Assistance Publique, Hopitaux de Paris, Universite Paris-Descartes, Paris, France. akostianovsky@gmail.com FAU - Hauser, Thomas AU - Hauser T FAU - Pagnoux, Christian AU - Pagnoux C FAU - Cohen, Pascal AU - Cohen P FAU - Daugas, Eric AU - Daugas E FAU - Mouthon, Luc AU - Mouthon L FAU - Miossec, Pierre AU - Miossec P FAU - Cordier, Jean-Francois AU - Cordier JF FAU - Guillevin, Loic AU - Guillevin L CN - French Vasculitis Study Group (FVSG) LA - eng PT - Journal Article DEP - 20120511 PL - Italy TA - Clin Exp Rheumatol JT - Clinical and experimental rheumatology JID - 8308521 RN - Rapidly progressive glomerulonephritis with pulmonary hemorrhage SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*complications/mortality/therapy MH - Databases, Factual MH - Female MH - Glomerulonephritis/etiology MH - Hemoptysis/*etiology/mortality/therapy MH - Hemorrhage/*etiology/mortality/therapy MH - Humans MH - Lung Diseases/*etiology/mortality/therapy MH - Male MH - Middle Aged MH - Prognosis MH - Recurrence MH - Retrospective Studies MH - Severity of Illness Index MH - Time Factors MH - Young Adult FIR - Bachmeyer, Claude IR - Bachmeyer C FIR - Barbier, Stephane IR - Barbier S FIR - Belmatoug, Nadia IR - Belmatoug N FIR - Bielefeld, Philips IR - Bielefeld P FIR - Bouredji, Daoud IR - Bouredji D FIR - Bourgarit, Anne IR - Bourgarit A FIR - Bruet, Alain IR - Bruet A FIR - Cadranel, Jacques IR - Cadranel J FIR - Chazerain, Pascal IR - Chazerain P FIR - Chinet, Thierry IR - Chinet T FIR - Coetmeur, Daniel IR - Coetmeur D FIR - Cottin, Vincent IR - Cottin V FIR - Delmolome-Rague, Sylvie IR - Delmolome-Rague S FIR - Dhote, Robin IR - Dhote R FIR - Girault, Anouk IR - Girault A FIR - Fauchias, Anne-Laurie IR - Fauchias AL FIR - Gobert, Pierre IR - Gobert P FIR - Godeau, Bertrand IR - Godeau B FIR - Hillion, Daniel IR - Hillion D FIR - Janin-Magnificant, Luc IR - Janin-Magnificant L FIR - Kaloustian, Edgar IR - Kaloustian E FIR - Kouyoumdjian, Laurence IR - Kouyoumdjian L FIR - Kyndt, Xavier IR - Kyndt X FIR - Israel-Biet, Dominique IR - Israel-Biet D FIR - de Lassence, Arnaud IR - de Lassence A FIR - Leclerc, Pascal IR - Leclerc P FIR - Le Jeunne, Claire IR - Le Jeunne C FIR - Le Noach, Jose IR - Le Noach J FIR - Lhote, Francois IR - Lhote F FIR - Lifermann, Francois IR - Lifermann F FIR - Lobbedez, Thierry IR - Lobbedez T FIR - Longuet, Olivier IR - Longuet O FIR - Pastural, Miriam IR - Pastural M FIR - Plaisier, Emmanuelle IR - Plaisier E FIR - Ponge, Thierry IR - Ponge T FIR - Roge, Christophe IR - Roge C FIR - Rince, Michel IR - Rince M FIR - Rondeau, Eric IR - Rondeau E FIR - Rossert, Jerome IR - Rossert J FIR - Roux, Marielle IR - Roux M FIR - Stern, Marc IR - Stern M FIR - Tanter, Yves IR - Tanter Y FIR - Tirot, Patrice IR - Tirot P FIR - Valeyre, Dominique IR - Valeyre D FIR - Vanhille, Philippe IR - Vanhille P FIR - Vidal, Elisabeth IR - Vidal E FIR - Vrtovsnik, Francois IR - Vrtovsnik F FIR - Zoulim, Abdelkader IR - Zoulim A EDAT- 2012/07/26 06:00 MHDA- 2012/08/14 06:00 CRDT- 2012/05/30 06:00 PHST- 2012/03/10 00:00 [received] PHST- 2012/04/13 00:00 [accepted] PHST- 2012/05/30 06:00 [entrez] PHST- 2012/07/26 06:00 [pubmed] PHST- 2012/08/14 06:00 [medline] AID - 5945 [pii] PST - ppublish SO - Clin Exp Rheumatol. 2012 Jan-Feb;30(1 Suppl 70):S77-82. Epub 2012 May 11.