Microscopic polyangiitis and polyarteritis nodosa: How and when do they start?
Microscopic polyangiitis and polyarteritis nodosa: How and when do they start?
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DOI：
10.1002/art.11387
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发表时间：
2003-10-15
期刊：
影响因子：
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通讯作者：
Guillevin, L
中科院分区：
文献类型：
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作者：
Agard, C;Mouthon, L;Guillevin, L
Objective.描述显微镜下多血管炎（MPA）或结节性多动脉炎（PAN）的初始临床症状。我们回顾性分析了72例经活检证实的MPA（n = 36）或PAN（n = 36）患者的医疗档案（平均随访6.7年）。除了周围神经病变（P = 0.02）和胃肠道受累（P = 0.006）在PAN中明显更常见，以及MPA中仅全身体征（8%; P = 0.02）外，两种疾病的初始表现相似。平均诊断时间为9.8 +/- 19.4个月; 35%的患者死亡，26%的患者复发; MPA患者复发率显著高于PAN患者（P = 0.03）。诊断时间大于或等于90天与更多患者复发的趋势相关（P = 40.12），但与死亡风险增加无关。MPA和PAN的初始症状通常是非特异性的，在诊断之前持续数月。诊断时间越长，复发率越高。
Objective. To describe initial clinical symptoms attributable to microscopic polyangiitis (MPA) or polyarteritis nodosa (PAN).Methods. We retrospectively reviewed the medical files of 72 patients (mean followup 6.7 years) with biopsy-proven MPA (n = 36) or PAN (n = 36).Results. Initial manifestations were similar in both entities except for peripheral neuropathy (P = 0.02) and gastrointestinal tract involvement (P = 0.006), which were significantly more frequent in PAN, and general signs alone in MPA (8%; P = 0.02). The mean time to diagnosis was 9.8 +/- 19.4 months; 35% of the patients died and 26% relapsed; significantly more MPA than PAN patients relapsed (P = 0.03). Time to diagnosis greater than or equal to90 days was associated with a trend toward more patients relapsing (P = 40.12), but not with an increased risk of mortality.Conclusion. Initial symptoms of MPA and PAN are usually nonspecific and last for several months before the diagnosis is made. A longer time to diagnosis is associated with a tendency to a higher relapse rate.