Background/Purpose: The objective of this study was to determine the prevalence and clinical characteristics of vasculitis in Alaska Native and American Indian (AN/AI) peoples of Alaska.

Methods: Potential cases of vasculitis in adults were identified by querying the electronic health records of participating tribal health organizations within the Alaska Tribal Health System (ATHS) for diagnostic codes related to vasculitis. Medical record abstraction was performed for all potential cases to confirm fulfillment of inclusion criteria, subtype, and clinical characteristics. The denominator for prevalence was the 2019 ATHS user population ≥ 18 (except giant cell arteritis (GCA), defined for persons ≥ 50).

Results: The age-adjusted prevalence per 1,000,000 AN/AI adults was 752 for all vasculitis, 518 for systemic vasculitis, 189 for leukocytoclastic vasculitis (skin only), and 44 for drug-associated vasculitis. The most common types of systemic vasculitis were antineutrophil cytoplasmic antibody-associated vasculitis (AAV) (340 per million adults) and GCA (28 per 100,000 ≥ 50). The most common subtype of AAV was granulomatosis with polyangiitis (GPA) (244 per million adults). There were no cases of hepatitis B-associated vasculitis. AAV was diagnosed at a mean age of 54.2 years, often with high inflammatory markers and significant renal involvement. GCA was diagnosed at a mean age of 69.6 years.

Conclusion: The prevalence of AAV (especially GPA) in the AN/AI peoples is among the highest in the world. GCA prevalence is lower than White populations, but higher than other populations. AN/AI peoples with AAV and GCA appear to present at younger ages and with more severe disease than other populations.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-and-clinical-characteristics-of-vasculitis-in-the-alaska-native-and-american-indian-peoples-of-alaska/