Relapses in patients with a systemic vasculitis.

Treatment with cyclophosphamide and steroids has greatly improved survival in patients with systemic necrotizing vasculitis but does not always provide a complete cure. There are as yet few data on the incidence, pattern and outcome of relapses in these diseases. We studied relapses in 150 consecuti...

Full description

Bibliographic Details
Main Authors: Gordon, M, Luqmani, R, Adu, D, Greaves, I, Richards, N, Michael, J, Emery, P, Howie, A, Bacon, P
Format: Journal article
Language:English
Published: 1993
_version_ 1797055377982881792
author Gordon, M
Luqmani, R
Adu, D
Greaves, I
Richards, N
Michael, J
Emery, P
Howie, A
Bacon, P
author_facet Gordon, M
Luqmani, R
Adu, D
Greaves, I
Richards, N
Michael, J
Emery, P
Howie, A
Bacon, P
author_sort Gordon, M
collection OXFORD
description Treatment with cyclophosphamide and steroids has greatly improved survival in patients with systemic necrotizing vasculitis but does not always provide a complete cure. There are as yet few data on the incidence, pattern and outcome of relapses in these diseases. We studied relapses in 150 consecutive patients with an idiopathic necrotizing vasculitis: 12 with classical polyarteritis (CPAN); 95 with microscopic polyarteritis (MPA); 28 with Wegener's granulomatosis (WG); and 15 with limited Wegener's granulomatosis (LWG). The relapse rates and median time to relapse in months were: CPAN, 41.7%/33; MPA, 25.4%/24; WG, 44%/42; LWG, 52%/18. The clinical features of relapse were similar to or more aggressive than those of the original presentation in CPAN and LWG and included renal disease for the first time, but in MPA and WG, relapse involved less renal involvement in the majority of cases. Laboratory tests, although often positive at relapse, were unhelpful in its prediction. The considerable accumulative non-fatal relapse rate contrasts with the very good long-term survival rates, and confirms the importance of long-term follow-up in systemic vasculitis.
first_indexed 2024-03-06T19:09:51Z
format Journal article
id oxford-uuid:1667a83f-8756-473c-8ee2-8ebab5426a23
institution University of Oxford
language English
last_indexed 2024-03-06T19:09:51Z
publishDate 1993
record_format dspace
spelling oxford-uuid:1667a83f-8756-473c-8ee2-8ebab5426a232022-03-26T10:31:08ZRelapses in patients with a systemic vasculitis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1667a83f-8756-473c-8ee2-8ebab5426a23EnglishSymplectic Elements at Oxford1993Gordon, MLuqmani, RAdu, DGreaves, IRichards, NMichael, JEmery, PHowie, ABacon, PTreatment with cyclophosphamide and steroids has greatly improved survival in patients with systemic necrotizing vasculitis but does not always provide a complete cure. There are as yet few data on the incidence, pattern and outcome of relapses in these diseases. We studied relapses in 150 consecutive patients with an idiopathic necrotizing vasculitis: 12 with classical polyarteritis (CPAN); 95 with microscopic polyarteritis (MPA); 28 with Wegener's granulomatosis (WG); and 15 with limited Wegener's granulomatosis (LWG). The relapse rates and median time to relapse in months were: CPAN, 41.7%/33; MPA, 25.4%/24; WG, 44%/42; LWG, 52%/18. The clinical features of relapse were similar to or more aggressive than those of the original presentation in CPAN and LWG and included renal disease for the first time, but in MPA and WG, relapse involved less renal involvement in the majority of cases. Laboratory tests, although often positive at relapse, were unhelpful in its prediction. The considerable accumulative non-fatal relapse rate contrasts with the very good long-term survival rates, and confirms the importance of long-term follow-up in systemic vasculitis.
spellingShingle Gordon, M
Luqmani, R
Adu, D
Greaves, I
Richards, N
Michael, J
Emery, P
Howie, A
Bacon, P
Relapses in patients with a systemic vasculitis.
title Relapses in patients with a systemic vasculitis.
title_full Relapses in patients with a systemic vasculitis.
title_fullStr Relapses in patients with a systemic vasculitis.
title_full_unstemmed Relapses in patients with a systemic vasculitis.
title_short Relapses in patients with a systemic vasculitis.
title_sort relapses in patients with a systemic vasculitis
work_keys_str_mv AT gordonm relapsesinpatientswithasystemicvasculitis
AT luqmanir relapsesinpatientswithasystemicvasculitis
AT adud relapsesinpatientswithasystemicvasculitis
AT greavesi relapsesinpatientswithasystemicvasculitis
AT richardsn relapsesinpatientswithasystemicvasculitis
AT michaelj relapsesinpatientswithasystemicvasculitis
AT emeryp relapsesinpatientswithasystemicvasculitis
AT howiea relapsesinpatientswithasystemicvasculitis
AT baconp relapsesinpatientswithasystemicvasculitis