Seasonal Influence on Development of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis: A Retrospective Cohort Study Conducted at Multiple Institutions in Japan (J-CANVAS)
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Published:2023-06-01
Issue:9
Volume:50
Page:1152-1158
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ISSN:0315-162X
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Container-title:The Journal of Rheumatology
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language:en
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Short-container-title:J Rheumatol
Author:
Yoshida YusukeORCID, Nakamoto Naoki, Oka Naoya, Kidoguchi Genki, Hosokawa Yohei, Araki Kei, Ishitoku Michinori, Watanabe Hirofumi, Sugimoto TomohiroORCID, Mokuda ShoORCID, Kida TakashiORCID, Yajima NobuyukiORCID, Omura Satoshi, Nakagomi DaikiORCID, Abe YoshiyukiORCID, Kadoya Masatoshi, Takizawa NaohoORCID, Nomura AtsushiORCID, Kukida YujiORCID, Kondo Naoya, Yamano Yasuhiko, Yanagida Takuya, Endo Koji, Matsui KiyoshiORCID, Takeuchi Tohru, Ichinose KunihiroORCID, Kato Masaru, Yanai Ryo, Matsuo Yusuke, Shimojima YasuhiroORCID, Nishioka Ryo, Okazaki Ryota, Takata TomoakiORCID, Ito TakafumiORCID, Moriyama Mayuko, Takatani Ayuko, Miyawaki YoshiaORCID, Ito-Ihara ToshikoORCID, Kawaguchi TakashiORCID, Kawahito YutakaORCID, Hirata ShintaroORCID
Abstract
ObjectiveTo clarify seasonal and other environmental effects on the onset of antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV).MethodsWe enrolled patients with new-onset eosinophilic granulomatosis with polyangiitis (EGPA), microscopic polyangiitis (MPA), and granulomatosis with polyangiitis (GPA) registered in the database of a Japanese multicenter cohort study. We investigated the relationship between environmental factors and clinical characteristics. Seasons were divided into 4 (spring, summer, autumn, and winter), and the seasonal differences in AAV onset were analyzed using Pearson chi-square test, with an expected probability of 25% for each season.ResultsA total of 454 patients were enrolled, with a mean age of 70.9 years and a female proportion of 55.5%. Overall, 74, 291, and 89 patients were classified as having EGPA, MPA, and GPA, respectively. Positivity for myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA was observed in 355 and 46 patients, respectively. Overall, the seasonality of AAV onset significantly deviated from the expected 25% for each season (P= 0.001), and its onset was less frequently observed in autumn. In ANCA serotypes, seasonality was significant in patients with MPO-ANCA (P< 0.001), but not in those with PR3-ANCA (P= 0.97). Additionally, rural residency of patients with AAV was associated with PR3-ANCA positivity and biopsy-proven pulmonary vasculitis.ConclusionThe onset of AAV was influenced by seasonal variations and was less frequently observed in autumn. In contrast, the occurrence of PR3-ANCA was triggered, not by season, but by rural residency.
Publisher
The Journal of Rheumatology
Subject
Immunology,Immunology and Allergy,Rheumatology
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