We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Comparison of patients with biopsy positive and negative primary angiitis of the central nervous system.
- Authors
Nehme, Ahmad; Arquizan, Caroline; Régent, Alexis; Isabel, Clothilde; Dequatre, Nelly; Guillon, Benoît; Capron, Jean; Detante, Olivier; Lanthier, Sylvain; Poppe, Alexandre Y; Boulouis, Grégoire; Godard, Sophie; Terrier, Benjamin; Pagnoux, Christian; Aouba, Achille; Touzé, Emmanuel; Boysson, Hubert de; Group, the Cohort of Patients with PACNS Study
- Abstract
Objective There is limited evidence on when to obtain a central nervous system (CNS) biopsy in suspected primary angiitis of the central nervous system (PACNS). Our objective was to identify which clinical and radiological characteristics were associated with a positive biopsy in PACNS. Methods From the multicentre retrospective Cohort of Patients with Primary Vasculitis of the CNS (COVAC), we included adults with PACNS based on a positive CNS biopsy or otherwise unexplained intracranial stenoses with additional findings supportive of vasculitis. Baseline findings were compared between patients with a positive and negative biopsy using logistic regression models. Results Two hundred patients with PACNS were included, among which a biopsy was obtained in 100 (50%) and was positive in 61 (31%). Patients with a positive biopsy were more frequently female (odds ratio [OR] 2.90; 95% CI: 1.25, 7.10; P = 0.01) and more often presented with seizures (OR 8.31; 95% CI: 2.77, 33.04; P < 0.001) or cognitive impairment (OR 2.58; 95% CI: 1.11, 6.10; P = 0.03). On imaging, biopsy positive patients more often had non-ischaemic parenchymal or leptomeningeal gadolinium enhancement (OR 52.80; 95% CI: 15.72, 233.06; P < 0.001) or ≥1 cerebral microbleed (OR 8.08; 95% CI: 3.03, 25.13; P < 0.001), and less often had ≥1 acute brain infarct (OR 0.02; 95% CI: 0.004, 0.08; P < 0.001). In the multivariable model, non-ischaemic parenchymal or leptomeningeal gadolinium enhancement (adjusted OR 8.27; 95% CI: 1.78, 38.46; P < 0.01) and absence of ≥1 acute brain infarct (adjusted OR 0.13; 95% CI: 0.03, 0.65; P = 0.01) were significantly associated with a positive biopsy. Conclusion Baseline clinical and radiological characteristics differed between biopsy positive and negative PACNS. These results may help physicians individualize the decision to obtain a CNS biopsy in suspected PACNS.
- Subjects
FRANCE; VASCULITIS; BIOPSY; STATISTICAL models; RESEARCH funding; T-test (Statistics); DIAGNOSTIC imaging; LOGISTIC regression analysis; FISHER exact test; COMPUTED tomography; SEX distribution; STENOSIS; SYMPTOMS; RETROSPECTIVE studies; DESCRIPTIVE statistics; MULTIVARIATE analysis; CHI-squared test; MANN Whitney U Test; ODDS ratio; RESEARCH; COGNITION disorders; STATISTICS; MAGNETIC resonance angiography; SEIZURES (Medicine); CENTRAL nervous system diseases; CONFIDENCE intervals; CEREBRAL infarction; DATA analysis software; CEREBRAL hemorrhage
- Publication
Rheumatology, 2024, Vol 63, Issue 7, p1973
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/kead542