Microscopic polyangiitis natural history, complications and prognosis: Difference between revisions
No edit summary |
|||
| (3 intermediate revisions by 3 users not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Microscopic polyangiitis}} | {{Microscopic polyangiitis}} | ||
{{CMG}}{{APM}};{{AE}}{{KW}} | {{CMG}}, {{APM}}; {{AE}}{{VKG}}, {{KW}} | ||
==Overview== | ==Overview== | ||
If left untreated, Microscopic polyangiitis can progress to end stage renal failure and respiratory failure. Complications of Microscopic polyangiitis include, alveolar hemorrhage, end stage renal failure, osteoarticular disease, and infections. The prognosis of Microscopic polyangiitis | If left untreated, [[Microscopic polyangiitis]] can progress to end stage [[Renal insufficiency|renal failure]] and [[respiratory failure]]. Complications of [[Microscopic polyangiitis]] include, [[alveolar]] [[hemorrhage]], [[end stage renal failure]], [[Osteoarticular pain|osteoarticular]] disease, and [[infections]]. The [[prognosis]] of Microscopic polyangiitis. | ||
==Natural History== | ==Natural History== | ||
| Line 10: | Line 10: | ||
==Complications== | ==Complications== | ||
Possible complications of Microscopic polyangiitis include: | Possible complications of Microscopic polyangiitis include: | ||
* | * Abdominal sepsis | ||
* | * Meningoencephalititis | ||
* | * Alveolar hemorrhage | ||
* | * Osteoarticular disease | ||
* | * End stage renal failure | ||
==Prognosis== | ==Prognosis== | ||
In the past the prognosis of Microscopic polyangiitis was fatal. Patients with Microscopic polyangiitis that was untreated had a mortality rate of about 90% in 2 years. With the advent of medications such as glucocorticoids and cyclophosphamide the mortality rate has decreased to a rate of 12 to 44 percent in about 4 to 10 years.<ref name="pmid21406467">{{cite journal| author=Corral-Gudino L, Borao-Cengotita-Bengoa M, Del Pino-Montes J, Lerma-Márquez JL| title=Overall survival, renal survival and relapse in patients with microscopic polyangiitis: a systematic review of current evidence. | journal=Rheumatology (Oxford) | year= 2011 | volume= 50 | issue= 8 | pages= 1414-23 | pmid=21406467 | doi=10.1093/rheumatology/ker112 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21406467 }}</ref> | In the past the prognosis of Microscopic polyangiitis was fatal. Patients with Microscopic polyangiitis that was untreated had a mortality rate of about 90% in 2 years. With the advent of medications such as glucocorticoids and cyclophosphamide the mortality rate has decreased to a rate of 12 to 44 percent in about 4 to 10 years.<ref name="pmid21406467">{{cite journal| author=Corral-Gudino L, Borao-Cengotita-Bengoa M, Del Pino-Montes J, Lerma-Márquez JL| title=Overall survival, renal survival and relapse in patients with microscopic polyangiitis: a systematic review of current evidence. | journal=Rheumatology (Oxford) | year= 2011 | volume= 50 | issue= 8 | pages= 1414-23 | pmid=21406467 | doi=10.1093/rheumatology/ker112 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21406467 }}</ref> | ||
| Line 36: | Line 36: | ||
|CNS involvement | |CNS involvement | ||
|} | |} | ||
According to the Five-Factor Score, a score of 0, 1, or greater than 2 has the following mortality rate | According to the Five-Factor Score, a score of 0, 1, or greater than 2 has the following mortality rate: | ||
{| | |||
{| | |||
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Five-Factor Score | |||
|- | |- | ||
|Score | | style="background:#7d7d7d; color: #FFFFFF;" align="center" + |Score | ||
|Mortality Rate | | style="background:#7d7d7d; color: #FFFFFF;" align="center" + |Mortality Rate | ||
|- | |- | ||
|0 | | style="background:#DCDCDC;" align="center" + |0 | ||
|12% | | style="background:#F5F5F5;" align="center" + |12% | ||
|- | |- | ||
|1 | | style="background:#DCDCDC;" align="center" + |1 | ||
|26% | | style="background:#F5F5F5;" align="center" + |26% | ||
|- | |- | ||
|>2 | | style="background:#DCDCDC;" align="center" + |>2 | ||
|46% | | style="background:#F5F5F5;" align="center" + |46% | ||
|} | |} | ||
It has also been concluded that age greater than 65 is also a risk factor for mortality.<sup>[[Churg-Strauss syndrome natural history, complications and prognosis|[4]]]</sup> | |||
*MPO‐ANCAs were a marker of poor survival and increased mortality rate in this population of patients with AAV.<ref name="pmid288814463">{{cite journal |vauthors=Berti A, Cornec D, Crowson CS, Specks U, Matteson EL |title=The Epidemiology of Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis in Olmsted County, Minnesota: A Twenty-Year US Population-Based Study |journal=Arthritis Rheumatol |volume=69 |issue=12 |pages=2338–2350 |date=December 2017 |pmid=28881446 |doi=10.1002/art.40313 |url=}}</ref> | |||
==References== | ==References== | ||
Latest revision as of 17:10, 7 June 2018
|
Microscopic polyangiitis Microchapters |
|
Differentiating Microscopic polyangiitis from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Microscopic polyangiitis natural history, complications and prognosis On the Web |
|
American Roentgen Ray Society Images of Microscopic polyangiitis natural history, complications and prognosis |
|
FDA on Microscopic polyangiitis natural history, complications and prognosis |
|
CDC on Microscopic polyangiitis natural history, complications and prognosis |
|
Microscopic polyangiitis natural history, complications and prognosis in the news |
|
Blogs on Microscopic polyangiitis natural history, complications and prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Ali Poyan Mehr, M.D. [2]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [3], Krzysztof Wierzbicki M.D. [4]
Overview
If left untreated, Microscopic polyangiitis can progress to end stage renal failure and respiratory failure. Complications of Microscopic polyangiitis include, alveolar hemorrhage, end stage renal failure, osteoarticular disease, and infections. The prognosis of Microscopic polyangiitis.
Natural History
If left untreated, Microscopic polyangiitis can progress to end stage renal disease and respiratory failure.
Complications
Possible complications of Microscopic polyangiitis include:
- Abdominal sepsis
- Meningoencephalititis
- Alveolar hemorrhage
- Osteoarticular disease
- End stage renal failure
Prognosis
In the past the prognosis of Microscopic polyangiitis was fatal. Patients with Microscopic polyangiitis that was untreated had a mortality rate of about 90% in 2 years. With the advent of medications such as glucocorticoids and cyclophosphamide the mortality rate has decreased to a rate of 12 to 44 percent in about 4 to 10 years.[1]
The following are favorable prognostic factors:
- Aggressive treatment with immunosuppressants together with a corticosteriod.
- Renal-pulmonary syndrome is not present.
The following are poor prognostic factors:
| Five-Factor Score Assessment |
|---|
| Proteinuria > 1g/d |
| Creatinine > 140mm/l |
| Cardiomyopathy |
| Severe GI manifestations |
| CNS involvement |
According to the Five-Factor Score, a score of 0, 1, or greater than 2 has the following mortality rate:
| Five-Factor Score | |
|---|---|
| Score | Mortality Rate |
| 0 | 12% |
| 1 | 26% |
| >2 | 46% |
It has also been concluded that age greater than 65 is also a risk factor for mortality.[4]
- MPO‐ANCAs were a marker of poor survival and increased mortality rate in this population of patients with AAV.[2]
References
- ↑ Corral-Gudino L, Borao-Cengotita-Bengoa M, Del Pino-Montes J, Lerma-Márquez JL (2011). "Overall survival, renal survival and relapse in patients with microscopic polyangiitis: a systematic review of current evidence". Rheumatology (Oxford). 50 (8): 1414–23. doi:10.1093/rheumatology/ker112. PMID 21406467.
- ↑ Berti A, Cornec D, Crowson CS, Specks U, Matteson EL (December 2017). "The Epidemiology of Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis in Olmsted County, Minnesota: A Twenty-Year US Population-Based Study". Arthritis Rheumatol. 69 (12): 2338–2350. doi:10.1002/art.40313. PMID 28881446.