Neurologic Involvement in Granulomatosis with Polyangiitis: A Comparative Study
Objective: The aim of this study was to describe the presentation and outcomes of patients with granulomatosis with polyangiitis (GPA) presenting with neurologic involvement according to ACR criteria. Methods: Consecutive newly diagnosed GPA patients who had undergone follow-up for at least six mont...
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MDPI AG
2023-01-01
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| Series: | Biology and Life Sciences Forum |
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| Online Access: | https://www.mdpi.com/2673-9976/19/1/19 |
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| author | Seyed Behnam Jazayeri Ahmad Rahimian Maral Seyed Ahadi Soheil Tavakolpour Samira Alesaeidi |
| author_facet | Seyed Behnam Jazayeri Ahmad Rahimian Maral Seyed Ahadi Soheil Tavakolpour Samira Alesaeidi |
| author_sort | Seyed Behnam Jazayeri |
| collection | DOAJ |
| description | Objective: The aim of this study was to describe the presentation and outcomes of patients with granulomatosis with polyangiitis (GPA) presenting with neurologic involvement according to ACR criteria. Methods: Consecutive newly diagnosed GPA patients who had undergone follow-up for at least six months between 2013 and 2018 at Amir-A’lam hospital, Tehran University of Medical Sciences, were retrospectively analyzed. Results: Patients were divided into two groups: those with nervous system involvement at either disease diagnosis or follow-up (89 patients) and those without neurological symptoms until the last follow-up (131 patients). From all patients reviewed in this study, 68 (30.9%) patients died during the follow-up period. Among the deceased patients, 18 (20.2%) were in the non-neurologic group, and 50 (38.2%) were in the neurologic group. The median (IQR) of BVAS in 220 patients was 11.0 (18.0-8.0) in total: 10.0 (14.5-7.50) and 12.0 (21.0-8.0) in the non-neurologic and the neurologic groups, respectively. The score of BVAS in the neurologic group was significantly higher than in the non-neurologic group (<i>p</i> = 0.039). Of 131 patients, sensory neuropathy was found in 99 patients (75.5%). In total, 95 patients (72.5%) complained of hearing loss, which was diagnosed as sensory–neural hearing loss; 27 patients (20.6%) complained of headache; 13 (9.9%) had a history of cerebrovascular events; 5 (3.8%) had an episode of seizure or loss of consciousness (LOC); and 3 (2.3%) had mononeuritis multiplex. Two patients (1.5%) were diagnosed with meningitis and two (1.7%) with encephalitis. Conclusion: According to this study, neurological symptoms are an undeniable part of the disease course for GPA patients, and these symptoms are associated with disease severity, prognosis, and response to treatment. |
| first_indexed | 2024-03-11T02:40:28Z |
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| institution | Directory Open Access Journal |
| issn | 2673-9976 |
| language | English |
| last_indexed | 2024-03-11T02:40:28Z |
| publishDate | 2023-01-01 |
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| series | Biology and Life Sciences Forum |
| spelling | doaj.art-21d5a1987bd84a2691d0d9b2dcdd79042023-11-18T09:35:17ZengMDPI AGBiology and Life Sciences Forum2673-99762023-01-011911910.3390/IECBS2022-13963Neurologic Involvement in Granulomatosis with Polyangiitis: A Comparative StudySeyed Behnam Jazayeri0Ahmad Rahimian1Maral Seyed Ahadi2Soheil Tavakolpour3Samira Alesaeidi4Internal Medicine ward Amiralam Hospital, Tehran University of Medical Sciences, Tehran 1145765111, IranDepartment of Internal Medicine, Amiralam Hospital, Tehran University of Medical Sciences, Tehran 1145765111, IranAmiralam Hospital, Tehran University of Medical Sciences, Tehran 1145765111, IranDana-Farber Cancer Institute, Harvard Medical School, Boston, MA 021155418, USADepartment of Internal Medicine, Amiralam Hospital, Tehran University of Medical Sciences, Tehran 1145765111, IranObjective: The aim of this study was to describe the presentation and outcomes of patients with granulomatosis with polyangiitis (GPA) presenting with neurologic involvement according to ACR criteria. Methods: Consecutive newly diagnosed GPA patients who had undergone follow-up for at least six months between 2013 and 2018 at Amir-A’lam hospital, Tehran University of Medical Sciences, were retrospectively analyzed. Results: Patients were divided into two groups: those with nervous system involvement at either disease diagnosis or follow-up (89 patients) and those without neurological symptoms until the last follow-up (131 patients). From all patients reviewed in this study, 68 (30.9%) patients died during the follow-up period. Among the deceased patients, 18 (20.2%) were in the non-neurologic group, and 50 (38.2%) were in the neurologic group. The median (IQR) of BVAS in 220 patients was 11.0 (18.0-8.0) in total: 10.0 (14.5-7.50) and 12.0 (21.0-8.0) in the non-neurologic and the neurologic groups, respectively. The score of BVAS in the neurologic group was significantly higher than in the non-neurologic group (<i>p</i> = 0.039). Of 131 patients, sensory neuropathy was found in 99 patients (75.5%). In total, 95 patients (72.5%) complained of hearing loss, which was diagnosed as sensory–neural hearing loss; 27 patients (20.6%) complained of headache; 13 (9.9%) had a history of cerebrovascular events; 5 (3.8%) had an episode of seizure or loss of consciousness (LOC); and 3 (2.3%) had mononeuritis multiplex. Two patients (1.5%) were diagnosed with meningitis and two (1.7%) with encephalitis. Conclusion: According to this study, neurological symptoms are an undeniable part of the disease course for GPA patients, and these symptoms are associated with disease severity, prognosis, and response to treatment.https://www.mdpi.com/2673-9976/19/1/19granulomatosis with polyangiitiscentral nervous systemneurologic manifestationsANCA |
| spellingShingle | Seyed Behnam Jazayeri Ahmad Rahimian Maral Seyed Ahadi Soheil Tavakolpour Samira Alesaeidi Neurologic Involvement in Granulomatosis with Polyangiitis: A Comparative Study Biology and Life Sciences Forum granulomatosis with polyangiitis central nervous system neurologic manifestations ANCA |
| title | Neurologic Involvement in Granulomatosis with Polyangiitis: A Comparative Study |
| title_full | Neurologic Involvement in Granulomatosis with Polyangiitis: A Comparative Study |
| title_fullStr | Neurologic Involvement in Granulomatosis with Polyangiitis: A Comparative Study |
| title_full_unstemmed | Neurologic Involvement in Granulomatosis with Polyangiitis: A Comparative Study |
| title_short | Neurologic Involvement in Granulomatosis with Polyangiitis: A Comparative Study |
| title_sort | neurologic involvement in granulomatosis with polyangiitis a comparative study |
| topic | granulomatosis with polyangiitis central nervous system neurologic manifestations ANCA |
| url | https://www.mdpi.com/2673-9976/19/1/19 |
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