We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Antineutrophil Cytoplasm Antibody-Associated Vasculitides Valvular Impairment: Multicenter Retrospective Study and Systematic Review of the Literature.
- Authors
Jeantin, Lina; Lenfant, Tiphaine; Bataille, Pierre; de Boysson, Hubert; Cathébras, Pascal; Agard, Christian; Faguer, Stanislas; Poindron, Vincent; Ruivard, Marc; Silva, Nicolas Martin; Monge, Matthieu; Guillevin, Loic; Puéchal, Xavier; Terrier, Benjamin; Dechartres, Agnès; Charles, Pierre
- Abstract
<bold>Objective: </bold>While myocardial impairment is a predictor of poor prognosis in antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV), little is known about valvular involvement. This study aims at describing the clinical presentation, management, and outcome of endocarditis associated with AAV.<bold>Methods: </bold>We conducted a multicenter retrospective study in centers affiliated with the French Vasculitis Study Group. We included patients with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), or eosinophilic GPA with endocardial impairment. A systematic review was then performed through PubMed, Embase, and Cochrane Library from inception up to September 2020.<bold>Results: </bold>The retrospective cohort included 9 patients (82%) with GPA, 1 (9%) with MPA, and 1 (9%) with unclassified AAV. Clinical presentation included acute valvular insufficiency (n = 7, 64%), cardiac failure (n = 3, 27%), dyspnea (n = 3, 27%), and no symptoms (n = 2, 18%). The aortic valve was the most frequently affected (n = 8/10, 80%), and vegetations were noted in 4 of 10 patients (40%). Six patients (55%) underwent surgical valvular replacement. No death from endocarditis was reported. The systematic review retrieved 42 patients from 40 references: 30 (71%) had GPA, 21 (50%) presented with vegetations, the aortic valve (n = 26, 62%) was the most frequently involved. Valvular replacement was required in 20 cases (48%) and 5 patients (13%) died from the endocarditic impairment.<bold>Conclusion: </bold>Endocarditis is a rare and potentially life-threatening manifestation of AAV. Acute valvular insufficiency may lead to urgent surgery. Implementing transthoracic echocardiography in standard assessment at baseline and follow-up of AAV might reduce the delay to diagnosis and allow earlier immunosuppressive treatment before surgery is needed.
- Subjects
AUTOIMMUNE disease diagnosis; VASCULITIS; AUTOANTIBODIES; ENDOCARDITIS; RETROSPECTIVE studies; GRANULOMATOSIS with polyangiitis; AUTOIMMUNE diseases; RESEARCH; CYTOPLASM; ARTHRITIS Impact Measurement Scales; DISEASE complications
- Publication
Journal of Rheumatology, 2022, Vol 49, Issue 12, p1349
- ISSN
0315-162X
- Publication type
Article
- DOI
10.3899/jrheum.211379