PMID- 31926833
OWN - NLM
STAT- MEDLINE
DCOM- 20210705
LR  - 20210705
IS  - 1095-9157 (Electronic)
IS  - 0896-8411 (Linking)
VI  - 108
DP  - 2020 Mar
TI  - Alveolar haemorrhage in ANCA-associated vasculitis: Long-term outcome and 
      mortality predictors.
PG  - 102397
LID - S0896-8411(19)30699-7 [pii]
LID - 10.1016/j.jaut.2019.102397 [doi]
AB  - INTRODUCTION: Alveolar haemorrhage (AH) is considered an important cause of 
      morbidity and early mortality in anti-neutrophil cytoplasmic antibodies 
      (ANCA)-associated vasculitides (AAV). OBJECTIVES: The aim of this study was to 
      identify predictors of outcome in patients with AH-AAV and to evaluate outcome 
      and causes of death in this subset. MATERIALS AND METHODS: A multicenter 
      retrospective study was conducted in 29 Italian Centers. Clinicians were asked to 
      recruit all patients diagnosed with AAV-associated AH during the last 10 years, 
      from 2007 to 2016. Univariate and multivariable analysis were performed. RESULTS: 
      One-hundred and six patients were included (median age at onset of 55 years [IQR 
      42-67]). The majority were ANCA-positive (PR3 57.1%, MPO 33.7%) and 72.6% had 
      also renal involvement. At presentation, anaemia was shown in 97 (92.4%) 
      patients, hemoptysis in 54 (51.9%), respiratory failure in 68 (66.7%), of whom 48 
      (70.6%), requiring respiratory support. At the end of the 37 months [IQR 13-77] 
      follow-up, 19/106 (17.9%) patients were dead. The main causes of death were 
      active disease and infections. By stepwise regression analysis, age >65 years (HR 
      3.66 [95% CI 1.4-9.51], p = 0.008) and the need for respiratory support (HR 4.58 
      [95% CI 1.51-13.87], p = 0.007) at AH onset were confirmed to be predictive of 
      mortality. CONCLUSIONS: Predictors of outcome in AAV-AH were determined. Factors 
      related to the patient's performance status and the severity of the lung 
      involvement strongly influenced the outcome. Balancing harms and benefits for the 
      individual patient in induction and maintenance treatment strategies is crucial.
CI  - Copyright (c) 2020 Elsevier Ltd. All rights reserved.
FAU - Quartuccio, Luca
AU  - Quartuccio L
AD  - Rheumatology Clinic, Department of Medicine, Academic Hospital "Santa Maria della 
      Misericordia", Udine, Italy. Electronic address: 
      luca.quartuccio@asuiud.sanita.fvg.it.
FAU - Bond, Milena
AU  - Bond M
AD  - Rheumatology Clinic, Department of Medicine, Academic Hospital "Santa Maria della 
      Misericordia", Udine, Italy.
FAU - Isola, Miriam
AU  - Isola M
AD  - Institute of Statistics, Department of Medical Area, University of Udine, Udine, 
      Italy.
FAU - Monti, Sara
AU  - Monti S
AD  - Department of Rheumatology, IRCCS Policlinico S. Matteo Fondazione, Pavia, Italy; 
      University of Pavia, PhD in Experimental Medicine, Pavia, Italy.
FAU - Felicetti, Mara
AU  - Felicetti M
AD  - Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
FAU - Furini, Federica
AU  - Furini F
AD  - Department of Medical Sciences, UOL Rheumatology, University of Ferrara, Ferrara, 
      Italy.
FAU - Murgia, Stefano
AU  - Murgia S
AD  - CMID-Center of Research of Nephrology, Rheumatology, and Rare Diseases 
      Interregional Coordinating Center of the Network of Rare Diseases of Piedmont and 
      Aosta Valley, Nephrology and Dialysis Unit (ERK-net Member) G. Bosco Hospital, 
      and University of Turin, Italy.
FAU - Berti, Alvise
AU  - Berti A
AD  - Department of Rheumatology, Santa Chiara Hospital, Trento, Italy.
FAU - Silvestri, Elena
AU  - Silvestri E
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
FAU - Pazzola, Giulia
AU  - Pazzola G
AD  - Azienda USL-IRCCS di Reggio Emilia and University of Modena and Reggio Emilia, 
      Italy.
FAU - Bozzolo, Enrica
AU  - Bozzolo E
AD  - Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San 
      Raffaele, Milan, Italy.
FAU - Leccese, Pietro
AU  - Leccese P
AD  - Rheumatology Department of Lucania - San Carlo Hospital, Potenza, Italy.
FAU - Raffeiner, Bernd
AU  - Raffeiner B
AD  - Rheumatology Unit, Department of Medicine, Centrale Hospital of Bolzano, Italy.
FAU - Parisi, Simone
AU  - Parisi S
AD  - S.C. Reumatologia, A.O.U. Citta della Salute e della Scienza di Torino, Turin, 
      Italy.
FAU - Leccese, Ilaria
AU  - Leccese I
AD  - Rheumatology Unit, Department of Internal Medicine and Medical Specialties, 
      Sapienza University of Rome, Italy.
FAU - Cianci, Francesco
AU  - Cianci F
AD  - Rheumatology Institute, Universita Cattolica del Sacro Cuore, Rome, Italy.
FAU - Bettio, Silvano
AU  - Bettio S
AD  - Rheumatology Unit, Internal Medicine Department, University Hospital of 
      Cattinara, Trieste, Italy.
FAU - Sainaghi, Pierpaolo
AU  - Sainaghi P
AD  - Rheumatology Unit, CAAD and DiMet, University of Eastern Piedmont and AOU 
      Maggiore della Carita, Novara, Italy.
FAU - Ianniello, Aurora
AU  - Ianniello A
AD  - Day Hospital Multidisciplinare, Ospedale di Borgomanero, ASL-NO Novara, Novara, 
      Italy.
FAU - Ravagnani, Viviana
AU  - Ravagnani V
AD  - SSD Allergologia Ed Immunologia Clinica, ASST Mantova, Italy.
FAU - Bellando Randone, Silvia
AU  - Bellando Randone S
AD  - Department of Experimental and Clinical Medicine University of Florence and 
      Division of Rheumatology AOUC, Florence, Italy.
FAU - Faggioli, Paola
AU  - Faggioli P
AD  - ASST Ovest Milanese, UOC Internal Medicine, Legnano, Italy.
FAU - Lomater, Claudia
AU  - Lomater C
AD  - SSD Reumatologia, Ospedale Mauriziano, Turin, Italy.
FAU - Stobbione, Paolo
AU  - Stobbione P
AD  - Reumatologia Ospedale Alessandria, Alessandria, Italy.
FAU - Ferro, Francesco
AU  - Ferro F
AD  - Rheumatology Unit, University of Pisa, Pisa, Italy.
FAU - Colaci, Michele
AU  - Colaci M
AD  - Dept Clinical and Experimental Medicine University of Catania, Catania, Italy.
FAU - Alfieri, Giuseppina
AU  - Alfieri G
AD  - Reumatologia ASST Lariana, Como, Italy.
FAU - Carubbi, Francesco
AU  - Carubbi F
AD  - Rheumatology Unit, ASL1 Avezzano-Sulmona-L'Aquila, L'Aquila, Italy.
FAU - Erre, Gian Luca
AU  - Erre GL
AD  - Reumatologia - AOU Sassari, Sassari, Italy.
FAU - Giollo, Alessandro
AU  - Giollo A
AD  - Rheumatology Section, Department of Medicine, University of Verona, Verona, 
      Italy.
FAU - Franzolini, Nicoletta
AU  - Franzolini N
AD  - Presidio Ospedaliero "S. Antonio", San Daniele (Udine), Italy.
FAU - Ditto, Maria Chiara
AU  - Ditto MC
AD  - S.C. Reumatologia, A.O.U. Citta della Salute e della Scienza di Torino, Turin, 
      Italy; University of Padua, PhD Program in Clinical and Experimental Sciences, 
      Padua, Italy.
FAU - Balduzzi, Silvia
AU  - Balduzzi S
AD  - Department of Rheumatology, IRCCS Policlinico S. Matteo Fondazione, Pavia, Italy.
FAU - Padoan, Roberto
AU  - Padoan R
AD  - Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
FAU - Bortolotti, Roberto
AU  - Bortolotti R
AD  - Department of Rheumatology, Santa Chiara Hospital, Trento, Italy.
FAU - Bortoluzzi, Alessandra
AU  - Bortoluzzi A
AD  - Department of Medical Sciences, UOL Rheumatology, University of Ferrara, Ferrara, 
      Italy.
FAU - Cariddi, Adriana
AU  - Cariddi A
AD  - Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San 
      Raffaele, Milan, Italy.
FAU - Padula, Angela
AU  - Padula A
AD  - Rheumatology Department of Lucania - San Carlo Hospital, Potenza, Italy.
FAU - Di Scala, Gerardo
AU  - Di Scala G
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
FAU - Gremese, Elisa
AU  - Gremese E
AD  - Rheumatology Institute, Universita Cattolica del Sacro Cuore, Rome, Italy; 
      Division of Rheumatology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 
      Rome, Italy.
FAU - Conti, Fabrizio
AU  - Conti F
AD  - Rheumatology Unit, Department of Internal Medicine and Medical Specialties, 
      Sapienza University of Rome, Italy.
FAU - D'Angelo, Salvatore
AU  - D'Angelo S
AD  - Rheumatology Department of Lucania - San Carlo Hospital, Potenza, Italy.
FAU - Matucci Cerinic, Marco
AU  - Matucci Cerinic M
AD  - Department of Experimental and Clinical Medicine University of Florence and 
      Division of Rheumatology AOUC, Florence, Italy.
FAU - Dagna, Lorenzo
AU  - Dagna L
AD  - Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San 
      Raffaele, Milan, Italy.
FAU - Emmi, Giacomo
AU  - Emmi G
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
FAU - Salvarani, Carlo
AU  - Salvarani C
AD  - Azienda USL-IRCCS di Reggio Emilia and University of Modena and Reggio Emilia, 
      Italy.
FAU - Paolazzi, Giuseppe
AU  - Paolazzi G
AD  - Department of Rheumatology, Santa Chiara Hospital, Trento, Italy.
FAU - Roccatello, Dario
AU  - Roccatello D
AD  - CMID-Center of Research of Nephrology, Rheumatology, and Rare Diseases 
      Interregional Coordinating Center of the Network of Rare Diseases of Piedmont and 
      Aosta Valley, Nephrology and Dialysis Unit (ERK-net Member) G. Bosco Hospital, 
      and University of Turin, Italy.
FAU - Govoni, Marcello
AU  - Govoni M
AD  - Department of Medical Sciences, UOL Rheumatology, University of Ferrara, Ferrara, 
      Italy.
FAU - Schiavon, Franco
AU  - Schiavon F
AD  - Rheumatology Unit, Department of Medicine DIMED, University of Padova, Italy.
FAU - Caporali, Roberto
AU  - Caporali R
AD  - Department of Rheumatology, IRCCS Policlinico S. Matteo Fondazione, Pavia, Italy.
FAU - De Vita, Salvatore
AU  - De Vita S
AD  - Rheumatology Clinic, Department of Medicine, Academic Hospital "Santa Maria della 
      Misericordia", Udine, Italy.
CN  - Italian Study Group on Lung Involvement in Rheumatic Diseases and the Italian 
      Vasculitis Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200109
PL  - England
TA  - J Autoimmun
JT  - Journal of autoimmunity
JID - 8812164
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated 
      Vasculitis/*complications/diagnosis/*epidemiology/mortality
MH  - Female
MH  - Hemorrhage/diagnosis/*epidemiology/*etiology/mortality
MH  - Humans
MH  - Italy/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Mortality
MH  - Prognosis
MH  - Public Health Surveillance
MH  - Pulmonary Alveoli/*pathology
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Alveolar haemorrhage
OT  - Mortality
OT  - Outcome
OT  - Vasculitis
COIS- Declaration of competing interest None.
EDAT- 2020/01/14 06:00
MHDA- 2021/07/06 06:00
CRDT- 2020/01/14 06:00
PHST- 2019/10/24 00:00 [received]
PHST- 2019/12/20 00:00 [revised]
PHST- 2019/12/20 00:00 [accepted]
PHST- 2020/01/14 06:00 [pubmed]
PHST- 2021/07/06 06:00 [medline]
PHST- 2020/01/14 06:00 [entrez]
AID - S0896-8411(19)30699-7 [pii]
AID - 10.1016/j.jaut.2019.102397 [doi]
PST - ppublish
SO  - J Autoimmun. 2020 Mar;108:102397. doi: 10.1016/j.jaut.2019.102397. Epub 2020 Jan 
      9.