Recent Advancements in the Management of Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis: A Systematic Review

Common clinical pattern of antineutrophil cytoplasmic antibody -associated vasculitis: An experience from a multicenter study in Saudi Arabia

OBJECTIVES

To understand the most common type and clinical manifestations of associated vasculitis (AAV) in the Saudi Arabia.

METHODS

This retrospective study was conducted at King Fahad Medical City and the Security Forces Hospital Program, Riyadh, Saudi Arabia, between January 2014 and May 2022. Patients aged ≥18 years were included in the study and diagnosed based on clinical manifestations, serology, or histopathology according to the EMA algorithm. Univariate analysis was carried out to compare different groups; a series of independent samples t-tests was applied for continuous data.

RESULTS

A total of 53 patients were enrolled: eosinophilic granulomatosis with polyangiitis (EGPA), granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA). Overall, proteinase-3 was the most prevalent (52.8%), and myeloperoxidase, myeloperoxidase MPO was the least prevalent antineutrophil cytoplasmic antibody (ANCA)-type (18.9%) among patients; other patients showed negative ANCA test results. The clinical manifestations differed significantly between EGPA and GPA groups in pulmonary, neurological, cardiological, and renal signs and symptoms (p<0.05); there was a higher incidence of the former 3 in the EGPA group. Although upper airway was predominant in all groups, there was no statistical difference between both groups.

CONCLUSION

This study validated international reports on AAV clinical manifestations in the Saudi population. The GPA was associated with more upper airway and pulmonary signs and symptoms. Further investigation is needed to understand the treatments and quality of life of patients with AAV.

Two Rare Diseases, One Patient: A Case Report of Mucormycosis and Granulomatous Polyangiitis

Mucormycosis is a rare but fatal disease caused by a filamentous fungus involving the nose, paranasal sinuses, and brain. These organisms usually cause severe infections in immunocompromised individuals. Granulomatous polyangiitis (GPA), also known as Wegner's granulomatosis, is a rare, aseptic necrotizing granulomatous vasculitis involving small and medium-sized vessels commonly affecting the nose, ears, lungs, and kidneys. The simultaneous occurrence of mucormycosis and GPA, two rare diseases, in the same patient is exceedingly rare. In this case study, we describe a 40-year-old woman who presented with manifestations of both GPA and mucormycosis. She was started with steroids and antifungal agents and achieved significant improvement.