PMID- 24078103
OWN - NLM
STAT- MEDLINE
DCOM- 20140331
LR  - 20211021
IS  - 1534-6307 (Electronic)
IS  - 1523-3774 (Linking)
VI  - 15
IP  - 11
DP  - 2013 Nov
TI  - Granuloma in ANCA-associated vasculitides: another reason to distinguish between 
      syndromes?
PG  - 376
LID - 10.1007/s11926-013-0376-5 [doi]
AB  - The 2012 renewed Chapel Hill Consensus Conference (CHCC) officially named three 
      clinicopathological entities, i.e. granulomatosis with polyangiitis (GPA), 
      eosinophilic granulomatosis with polyangiitis (EGPA), and microscopic 
      polyangiitis (MPA), as major variants of anti-neutrophil cytoplasmic antibody 
      (ANCA)-associated vasculitides (AAV). Recent genetic and cohort studies revealed 
      the need for further differentiation between the entities, for example regarding 
      differences in outcome. As well as ANCA reactivity, upper and lower airway 
      disease were found to be differentiating factors for AAV variants, improving 
      prognostic ability regarding relapse prediction and associated clinical features. 
      Extravascular granulomatosis, or "granuloma", which describes both clinically 
      relevant granulomatous manifestations and histopathologically documented 
      granulomatous inflammation, is characteristic of localized and systemic GPA, but 
      not MPA. This review summarizes new knowledge regarding granuloma in the head and 
      neck region of AAV, its histomorphological equivalents in the upper and lower 
      respiratory tract, and evidence for a granulomatous phenotype of a persistent 
      localized GPA variant. This comprises the development of disease activity and 
      damage scores for extravascular lesions in the ear, nose, and throat (ENT) 
      regions, and imaging techniques. In addition, findings linking extravascular 
      manifestations to granulomatous inflammation are described. We hypothesize that, 
      as for ANCA, necrotizing granulomatous inflammation and its clinical 
      manifestations are discriminators, assisting subclassification of AAV and/or GPA 
      subphenotypes which will be useful both for designing clinical trials and for 
      treating patients successfully.
FAU - Mueller, Antje
AU  - Mueller A
AD  - Department of Rheumatology, University of Luebeck, Ratzeburger Allee 160, 23538, 
      Luebeck, Germany, antje.mueller@uksh.de.
FAU - Holl-Ulrich, Konstanze
AU  - Holl-Ulrich K
FAU - Gross, Wolfgang L
AU  - Gross WL
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Curr Rheumatol Rep
JT  - Current rheumatology reports
JID - 100888970
SB  - IM
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated 
      Vasculitis/classification/*complications/diagnosis/genetics
MH  - Genome-Wide Association Study
MH  - Granuloma/*etiology
MH  - Humans
MH  - Prognosis
MH  - Recurrence
EDAT- 2013/10/01 06:00
MHDA- 2014/04/01 06:00
CRDT- 2013/10/01 06:00
PHST- 2013/10/01 06:00 [entrez]
PHST- 2013/10/01 06:00 [pubmed]
PHST- 2014/04/01 06:00 [medline]
AID - 10.1007/s11926-013-0376-5 [doi]
PST - ppublish
SO  - Curr Rheumatol Rep. 2013 Nov;15(11):376. doi: 10.1007/s11926-013-0376-5.