Bronchiectasis Are Highly Prevalent in Anti-MPO ANCA-Associated Vasculitis and Associate with a Distinct Disease Phenotype

Antoine Néel¹, Alexandra Espitia¹, Pierre Paul Arrigoni², Christelle Volteau³, Agathe Masseau¹, Marie Rimbert⁴, Christian Agard¹, Fadi Fakhouri⁵, Renan Liberge² and Mohamed Hamidou⁶, ¹Internal Medicine Department, Nantes University Hospital, Nantes, France, ²Radiology Department, Nantes University Hospital, Nantes, France, ³Clinical Research Department, Nantes University Hospital, Nantes, France, ⁴Immunology Laboratory, Nantes University Hospital, Nantes, France, ⁵Nephrology Department, Nantes University Hospital, Nantes, France, ⁶Internal Medicine Department, Internal Medicine Department, Nantes University Hospital, Nantes, France

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: ANCA, Copd, respiratory disease and vasculitis

Session Information

Date: Monday, November 14, 2016

Title: Vasculitis - Poster II: ANCA-Associated Vasculitis

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: To assess the prevalence of bronchiectasis in a western cohort of ANCA positive GPA or MPA and its correlations with disease phenotype and outcome.

Methods: Retrospective study of AAV patients followed at Nantes University Hospital (2005-2015). Clinical, biological and follow-up data were collected through chart review. Chest High-Resolution CTs were interpreted by 2 experienced radiologists blinded to the clinical data, using Feischner Society criteria.

Results: Fifty eight patients were included, 30 patients had MPA (51,7%) and 28 patients had GPA (48,3%). Anti-MPO-ANCA and anti-PR3-ANCA were present in 39 (67,2%) had 19 (32,8%) patients, respectively. Overall, bronchiectasis were found in 22 patients (37,9%), all of whom had anti-MPO ANCA. Representative images from 3 patients are shown in Figure 1. In multivariate analysis, bronchiectasis were independently associated with anti-MPO-ANCA, female gender and age at AAV diagnosis. Further, anti-MPO ANCA patients with bronchiectasis had more frequent peripheral nerve involvement (54,5 vs 17,6%, p=0.019) and less frequent renal involvement than those without bronchiectasis (40,9% vs 82,3%, p=0,009). Disease course, survival and risk of severe pulmonary infection was similar in patients with/without bronchiectasis on chest CT.

Conclusion: Bronchiectasis is an underestimated pre-existing respiratory condition in Caucasian patients with anti-MPO AAV. This subset of patients exhibits a distinct phenotype but similar outcomes. Further studies are needed to confirm our findings and enlighten the clinical implications of this association. Whether the respiratory tract could be the site of initiation of anti-MPO auto-immunity remains to be investigated.

Disclosure: A. Néel, None; A. Espitia, None; P. P. Arrigoni, None; C. Volteau, None; A. Masseau, None; M. Rimbert, None; C. Agard, None; F. Fakhouri, None; R. Liberge, None; M. Hamidou, None.

To cite this abstract in AMA style:

Néel A, Espitia A, Arrigoni PP, Volteau C, Masseau A, Rimbert M, Agard C, Fakhouri F, Liberge R, Hamidou M. Bronchiectasis Are Highly Prevalent in Anti-MPO ANCA-Associated Vasculitis and Associate with a Distinct Disease Phenotype [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/bronchiectasis-are-highly-prevalent-in-anti-mpo-anca-associated-vasculitis-and-associate-with-a-distinct-disease-phenotype/. Accessed .

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