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Alfuwayris JJ, Almulhim AM, Almansour MA, Albadi MA, Alhomood IA, Alblewi F, Althemery AU. Common clinical pattern of antineutrophil cytoplasmic antibody -associated vasculitis: An experience from a multicenter study in Saudi Arabia. Saudi Med J 2023; 44:486-491. [PMID: 37182925 PMCID: PMC10187742 DOI: 10.15537/smj.2023.44.5.20220818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
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.
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Affiliation(s)
- Jumanah J. Alfuwayris
- From the Department of Rheumatology (Alfuwayris), Ministry of the National Guard – Health Affairs, King Abdullah International Medical Research Center, from the Department of Rheumatology (Alfuwayris), King Saud bin Abdulaziz University for Health Sciences; from Department of Rheumatology, King Fahad Medical City (Almulhim, Almansour, Alhomood, Alblewi); from Rheumatology Division (Albadi), Security Forces Hospital, Riyadh; and from Department of Clinical Pharmacy (Althemery), College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia.
| | - Amal M. Almulhim
- From the Department of Rheumatology (Alfuwayris), Ministry of the National Guard – Health Affairs, King Abdullah International Medical Research Center, from the Department of Rheumatology (Alfuwayris), King Saud bin Abdulaziz University for Health Sciences; from Department of Rheumatology, King Fahad Medical City (Almulhim, Almansour, Alhomood, Alblewi); from Rheumatology Division (Albadi), Security Forces Hospital, Riyadh; and from Department of Clinical Pharmacy (Althemery), College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia.
| | - Mohammed A. Almansour
- From the Department of Rheumatology (Alfuwayris), Ministry of the National Guard – Health Affairs, King Abdullah International Medical Research Center, from the Department of Rheumatology (Alfuwayris), King Saud bin Abdulaziz University for Health Sciences; from Department of Rheumatology, King Fahad Medical City (Almulhim, Almansour, Alhomood, Alblewi); from Rheumatology Division (Albadi), Security Forces Hospital, Riyadh; and from Department of Clinical Pharmacy (Althemery), College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia.
| | - Marzouq A. Albadi
- From the Department of Rheumatology (Alfuwayris), Ministry of the National Guard – Health Affairs, King Abdullah International Medical Research Center, from the Department of Rheumatology (Alfuwayris), King Saud bin Abdulaziz University for Health Sciences; from Department of Rheumatology, King Fahad Medical City (Almulhim, Almansour, Alhomood, Alblewi); from Rheumatology Division (Albadi), Security Forces Hospital, Riyadh; and from Department of Clinical Pharmacy (Althemery), College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia.
| | - Ibrahim A. Alhomood
- From the Department of Rheumatology (Alfuwayris), Ministry of the National Guard – Health Affairs, King Abdullah International Medical Research Center, from the Department of Rheumatology (Alfuwayris), King Saud bin Abdulaziz University for Health Sciences; from Department of Rheumatology, King Fahad Medical City (Almulhim, Almansour, Alhomood, Alblewi); from Rheumatology Division (Albadi), Security Forces Hospital, Riyadh; and from Department of Clinical Pharmacy (Althemery), College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia.
| | - Faisal Alblewi
- From the Department of Rheumatology (Alfuwayris), Ministry of the National Guard – Health Affairs, King Abdullah International Medical Research Center, from the Department of Rheumatology (Alfuwayris), King Saud bin Abdulaziz University for Health Sciences; from Department of Rheumatology, King Fahad Medical City (Almulhim, Almansour, Alhomood, Alblewi); from Rheumatology Division (Albadi), Security Forces Hospital, Riyadh; and from Department of Clinical Pharmacy (Althemery), College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia.
| | - Abdullah U. Althemery
- From the Department of Rheumatology (Alfuwayris), Ministry of the National Guard – Health Affairs, King Abdullah International Medical Research Center, from the Department of Rheumatology (Alfuwayris), King Saud bin Abdulaziz University for Health Sciences; from Department of Rheumatology, King Fahad Medical City (Almulhim, Almansour, Alhomood, Alblewi); from Rheumatology Division (Albadi), Security Forces Hospital, Riyadh; and from Department of Clinical Pharmacy (Althemery), College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia.
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Aasia Batool S, Kumari U, Surani S. Two Rare Diseases, One Patient: A Case Report of Mucormycosis and Granulomatous Polyangiitis. Case Rep Infect Dis 2023; 2023:7934700. [PMID: 37207042 PMCID: PMC10191744 DOI: 10.1155/2023/7934700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/23/2023] [Accepted: 04/27/2023] [Indexed: 05/21/2023] Open
Abstract
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.
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Affiliation(s)
| | - Usha Kumari
- Dow University of Health Sciences, Karachi, Pakistan
| | - Salim Surani
- Medicine & Pharmacology, Texas A&M University, College Station, Texas, USA
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