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The clinical pattern differentiates ANCA-positive infective endocarditis patients from ANCA-associated vasculitis patients: a 23 years’ retrospective cohort study in China and follow-ups

OBJECTIVES: Patients with infective endocarditis (IE) may present rheumatic manifestations concurrent with various autoantibodies and thus mimic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). This study aims to characterize the specific features in a long-term cohort of ANCA...

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Autores principales: Wang, Fan, Zhou, Zhuochao, Teng, Jialin, Sun, Yue, You, Yijun, Su, Yutong, Hu, Qiongyi, Liu, Honglei, Cheng, Xiaobing, Shi, Hui, Yang, Chengde, Ye, Junna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562078/
https://www.ncbi.nlm.nih.gov/pubmed/35906495
http://dx.doi.org/10.1007/s10067-022-06313-w
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author Wang, Fan
Zhou, Zhuochao
Teng, Jialin
Sun, Yue
You, Yijun
Su, Yutong
Hu, Qiongyi
Liu, Honglei
Cheng, Xiaobing
Shi, Hui
Yang, Chengde
Ye, Junna
author_facet Wang, Fan
Zhou, Zhuochao
Teng, Jialin
Sun, Yue
You, Yijun
Su, Yutong
Hu, Qiongyi
Liu, Honglei
Cheng, Xiaobing
Shi, Hui
Yang, Chengde
Ye, Junna
author_sort Wang, Fan
collection PubMed
description OBJECTIVES: Patients with infective endocarditis (IE) may present rheumatic manifestations concurrent with various autoantibodies and thus mimic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). This study aims to characterize the specific features in a long-term cohort of ANCA-positive IE patients and to perform comparative analysis with primary AAV patients. METHODS: We performed a retrospective thorough review of 475 consecutive IE patients over 23 years, identifying 22 patients positive for proteinase 3 and/or myeloperoxidase and 36 treatment-naïve AAV patients. The clinical, laboratory, and follow-up data were collected to perform comparative analysis. RESULTS: Our study illustrated that ANCA-positive IE patients were younger and had a shorter duration than AAV patients. Pulmonary lesions, ENT signs, peripheral neuropath, and proteinuria were more commonly seen in AAV patients, while heart valve involvement, spleen enlargement, and cerebral hemorrhage were more typical for IE patients (all p < 0.05). Besides, ANCA-positive IE patients presented a higher level of PR3-ANCA but lower C3 (both p < 0.05). Hyperleukocytosis and thrombocytopenia were more frequently found in AAV patients (both p < 0.05). No significant difference was noticed in the survival rate. CONCLUSIONS: Our study urges the early differential diagnosis of IE in ANCA-positive patients. It supports the claim that ANCA-positive IE patients and AAV patients do not share the same clinical spectrum. Echocardiography, serological profiles, and evaluation of multi-organ involvement might be required to improve diagnostic accuracy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10067-022-06313-w.
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spelling pubmed-95620782022-10-14 The clinical pattern differentiates ANCA-positive infective endocarditis patients from ANCA-associated vasculitis patients: a 23 years’ retrospective cohort study in China and follow-ups Wang, Fan Zhou, Zhuochao Teng, Jialin Sun, Yue You, Yijun Su, Yutong Hu, Qiongyi Liu, Honglei Cheng, Xiaobing Shi, Hui Yang, Chengde Ye, Junna Clin Rheumatol Original Article OBJECTIVES: Patients with infective endocarditis (IE) may present rheumatic manifestations concurrent with various autoantibodies and thus mimic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). This study aims to characterize the specific features in a long-term cohort of ANCA-positive IE patients and to perform comparative analysis with primary AAV patients. METHODS: We performed a retrospective thorough review of 475 consecutive IE patients over 23 years, identifying 22 patients positive for proteinase 3 and/or myeloperoxidase and 36 treatment-naïve AAV patients. The clinical, laboratory, and follow-up data were collected to perform comparative analysis. RESULTS: Our study illustrated that ANCA-positive IE patients were younger and had a shorter duration than AAV patients. Pulmonary lesions, ENT signs, peripheral neuropath, and proteinuria were more commonly seen in AAV patients, while heart valve involvement, spleen enlargement, and cerebral hemorrhage were more typical for IE patients (all p < 0.05). Besides, ANCA-positive IE patients presented a higher level of PR3-ANCA but lower C3 (both p < 0.05). Hyperleukocytosis and thrombocytopenia were more frequently found in AAV patients (both p < 0.05). No significant difference was noticed in the survival rate. CONCLUSIONS: Our study urges the early differential diagnosis of IE in ANCA-positive patients. It supports the claim that ANCA-positive IE patients and AAV patients do not share the same clinical spectrum. Echocardiography, serological profiles, and evaluation of multi-organ involvement might be required to improve diagnostic accuracy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10067-022-06313-w. Springer International Publishing 2022-07-29 2022 /pmc/articles/PMC9562078/ /pubmed/35906495 http://dx.doi.org/10.1007/s10067-022-06313-w Text en © The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR) 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Wang, Fan
Zhou, Zhuochao
Teng, Jialin
Sun, Yue
You, Yijun
Su, Yutong
Hu, Qiongyi
Liu, Honglei
Cheng, Xiaobing
Shi, Hui
Yang, Chengde
Ye, Junna
The clinical pattern differentiates ANCA-positive infective endocarditis patients from ANCA-associated vasculitis patients: a 23 years’ retrospective cohort study in China and follow-ups
title The clinical pattern differentiates ANCA-positive infective endocarditis patients from ANCA-associated vasculitis patients: a 23 years’ retrospective cohort study in China and follow-ups
title_full The clinical pattern differentiates ANCA-positive infective endocarditis patients from ANCA-associated vasculitis patients: a 23 years’ retrospective cohort study in China and follow-ups
title_fullStr The clinical pattern differentiates ANCA-positive infective endocarditis patients from ANCA-associated vasculitis patients: a 23 years’ retrospective cohort study in China and follow-ups
title_full_unstemmed The clinical pattern differentiates ANCA-positive infective endocarditis patients from ANCA-associated vasculitis patients: a 23 years’ retrospective cohort study in China and follow-ups
title_short The clinical pattern differentiates ANCA-positive infective endocarditis patients from ANCA-associated vasculitis patients: a 23 years’ retrospective cohort study in China and follow-ups
title_sort clinical pattern differentiates anca-positive infective endocarditis patients from anca-associated vasculitis patients: a 23 years’ retrospective cohort study in china and follow-ups
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562078/
https://www.ncbi.nlm.nih.gov/pubmed/35906495
http://dx.doi.org/10.1007/s10067-022-06313-w
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