1. Characteristics and outcome of ANCA-associated vasculitides induced by anti-thyroid drugs: a multicentre retrospective case-control study
- Author
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Culerrier, J, Nguyen, Y, Karadag, O, Yasar Bilge, S, Demirci Yıldırım, T, Saygin Ögüt, T, Yazisiz, V, Bes, C, Celfe, A, Yazici, A, Sadioglu Cagdas, O, Kronbichler, A, Jayne, D, Gauckler, P, Regent, A, Teixeira, V, Marchand-Adam, S, Duffau, P, Ingen-Housz-Oro, S, Droumaguet, C, Andre, B, Luca, L, Lechtman, S, Aouba, A, Lebas, C, Servettaz, A, Dernoncourt, A, Ruivard, M, Milesi, A, Poindron, V, Jego, P, Padoan, R, Delvino, P, Vandergheynst, F, Pagnoux, C, Yacyshyn, E, Lamprecht, P, Flossmann, O, Puéchal, X, Terrier, B, Julien Culerrier, Yann Nguyen, Omer Karadag, Sule Yasar Bilge, Tuba Demirci Yıldırım, Tahir Saygin Ögüt, Veli Yazisiz, Cemal Bes, Ayse Celfe, Ayten Yazici, Oznur Sadioglu Cagdas, Andreas Kronbichler, David Jayne, Philipp Gauckler, Alexis Regent, Vitor Teixeira, Sylvain Marchand-Adam, Pierre Duffau, Saskia Ingen-Housz-Oro, Celine Droumaguet, Baptiste Andre, Luminita Luca, Sarah Lechtman, Achille Aouba, Celine Lebas, Amélie Servettaz, Amandine Dernoncourt, Marc Ruivard, Anne-Marie Milesi, Vincent Poindron, Patrick Jego, Roberto Padoan, Paolo Delvino, Frédéric Vandergheynst, christian pagnoux, Elaine Yacyshyn, Peter Lamprecht, Oliver Flossmann, Xavier Puéchal, Benjamin Terrier, Culerrier, J, Nguyen, Y, Karadag, O, Yasar Bilge, S, Demirci Yıldırım, T, Saygin Ögüt, T, Yazisiz, V, Bes, C, Celfe, A, Yazici, A, Sadioglu Cagdas, O, Kronbichler, A, Jayne, D, Gauckler, P, Regent, A, Teixeira, V, Marchand-Adam, S, Duffau, P, Ingen-Housz-Oro, S, Droumaguet, C, Andre, B, Luca, L, Lechtman, S, Aouba, A, Lebas, C, Servettaz, A, Dernoncourt, A, Ruivard, M, Milesi, A, Poindron, V, Jego, P, Padoan, R, Delvino, P, Vandergheynst, F, Pagnoux, C, Yacyshyn, E, Lamprecht, P, Flossmann, O, Puéchal, X, Terrier, B, Julien Culerrier, Yann Nguyen, Omer Karadag, Sule Yasar Bilge, Tuba Demirci Yıldırım, Tahir Saygin Ögüt, Veli Yazisiz, Cemal Bes, Ayse Celfe, Ayten Yazici, Oznur Sadioglu Cagdas, Andreas Kronbichler, David Jayne, Philipp Gauckler, Alexis Regent, Vitor Teixeira, Sylvain Marchand-Adam, Pierre Duffau, Saskia Ingen-Housz-Oro, Celine Droumaguet, Baptiste Andre, Luminita Luca, Sarah Lechtman, Achille Aouba, Celine Lebas, Amélie Servettaz, Amandine Dernoncourt, Marc Ruivard, Anne-Marie Milesi, Vincent Poindron, Patrick Jego, Roberto Padoan, Paolo Delvino, Frédéric Vandergheynst, christian pagnoux, Elaine Yacyshyn, Peter Lamprecht, Oliver Flossmann, Xavier Puéchal, and Benjamin Terrier
- Abstract
Objective: Data on ANCA-associated vasculitis (AAV) induced by anti-thyroid drugs (ATD) are scarce. We aimed to describe the characteristics and outcome of these patients in comparison to primary AAV. Methods: We performed a retrospective multicentre study including patients with ATD-induced AAV. We focused on ATD-induced microscopic polyangiitis (MPA) and compared them with primary MPA by matching each case with four controls by gender and year of diagnosis. Results: Forty-five patients with ATD-induced AAV of whom 24 MPA were included. ANCA were positive in 44 patients (98%), including myeloperoxidase (MPO)-ANCA in 21 (47%), proteinase 3 (PR3)-ANCA in six (13%), and double positive MPO- and PR3-ANCA in 15 (33%). Main clinical manifestations were skin involvement (64%), arthralgia (51%) and glomerulonephritis (20%). ATD was discontinued in 98% of cases, allowing vasculitis remission in seven (16%). All the remaining patients achieved remission after glucocorticoids, in combination with rituximab in 11 (30%) or cyclophosphamide in four (11%). ATD were reintroduced in seven cases (16%) without any subsequent relapse. Compared with 96 matched primary MPA, ATD-induced MPA were younger at diagnosis (48 vs 65 years, P < 0.001), had more frequent cutaneous involvement (54 vs 25%, P 1⁄4 0.007), but less frequent kidney (38 vs 73%, P 1⁄4 0.02), and a lower risk of relapse (adjusted HR 0.07; 95% CI 0.01, 0.65, P 1⁄4 0.019). Conclusion: ATD-induced AAV were mainly MPA with MPO-ANCA, but double MPO- and PR3-ANCA positivity was frequent. The most common manifestations were skin and musculoskeletal manifestations. ATD-induced MPA were less severe and showed a lower risk of relapse than primary MPA.
- Published
- 2024