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    Home > Active Ingredient News > Immunology News > ARD: 2022 American College of Rheumatology/Confederation of European Societies of Rheumatology Microscopic Classification Criteria for Polyangiitis

    ARD: 2022 American College of Rheumatology/Confederation of European Societies of Rheumatology Microscopic Classification Criteria for Polyangiitis

    • Last Update: 2022-04-17
    • Source: Internet
    • Author: User
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      Objectives: The main distinguishing feature between MPA ( microscopic polyangiitis ) and PAN (polyarteritis nodosa ) is the presence of oligoimmune vasculitis in arterioles, venules, or capillaries in MPA .
    PAN is a disease limited to medium vessels, and MPA is a mainly small vessel vasculitis that can also involve medium vessels .
    The purpose of this article is to develop and validate classification criteria for microscopic polyangiitis (MPA) .



    The main distinguishing feature between MPA ( microscopic polyangiitis vasculitis ) and PAN ) is the presence of oligoimmune vasculitis in arterioles , venules, or capillaries in MPA .
    Immune PAN is limited to medium-vessel disease, and MPA is a predominantly small-vessel disease that can also involve medium-vessel disease .
    The purpose of this article is to develop and validate classification criteria for microscopic polyangiitis (MPA) .



       Methods: Patients with vasculitis or comparative disease were recruited into an international cohort
    .
    The study was conducted in five phases : ( 1 ) identification of candidates using a consensus approach, ( 2 ) prospective collection of candidates at diagnosis , ( 3 ) data-driven reduction of the number of candidates, and ( 4 ) case review by an expert panel to determine Score-based risk scores for disease classification were derived in the development set using least absolute shrinkage and selection operator logistic regression with reference to diagnosis and (5) , and performance was subsequently validated in an independent set of characteristic cases and comparative diseases .

       Methods: Patients with vasculitis or comparative disease were recruited into an international cohort
    .
    The study was conducted in five phases : ( 1 ) identification of candidate items using a consensus approach, ( consensus 2 ) prospective collection of candidate items at diagnosis , ( diagnosis 3 ) data-driven reduction of the number of candidate items, ( 4 ) case review by an expert panel To determine reference diagnoses and (5) use least absolute shrinkage and selection operator logistic regression to derive score-based risk scores for disease classification in the development set, performance was subsequently validated in an independent set of characteristic cases and comparative diseases
    .

        RESULTS: The development dataset for MPA included 149 MPA and 408 comparative cases .
    The validation set consisted of an additional 142 MPAs and 414 comparison cases .
    From the 91 candidate items, regression analysis identified 10 MPA items , of which 6 were retained .
    Final criteria and their weights were as follows: perinuclear anti-neutrophil cytoplasmic antibody ( ANCA ) or anti-myeloperoxidase- ANCA positive ( +6 ), oligoimmune glomerulonephritis ( +3 ), pulmonary fibrosis or Isolate lung disease ( +3 ), sino- nasal symptoms or signs (-3) , cytoplasmic ANCA or antiprotease 3 ANCA positivity (-1) and eosinophil count



    1 × 109/L (-4)
    .
    After excluding vasculitis-like conditions, patients diagnosed with small or medium vasculitis can be classified as
    MPA with a cumulative score of ≥ 5 .
    When testing these criteria in the validation dataset, the sensitivity was 91% ( 95% CI 85% to 95% ) and the specificity was 94% ( 95% CI 92% to 96% ) .


        RESULTS: The development dataset for MPA included 149 MPA and 408 comparative cases .
    The validation set consisted of an additional 142 MPAs and 414 comparison cases .
    From the 91 candidate items, regression analysis identified 10 MPA items , of which 6 were retained .
    Final criteria and their weights were as follows: perinuclear anti-neutrophil cytoplasmic antibody ( ANCA ) or anti-myeloperoxidase- ANCA positive ( +6 ), oligoimmune glomerulonephritis ( +3 ), pulmonary fibrosis or Isolate lung disease ( +3 ), sino- nasal symptoms or signs (-3) , cytoplasmic ANCA or antiprotease 3 ANCA positivity (-1) and eosinophil count



    1 × 109/L (-4)
    .
    After excluding vasculitis-like conditions, patients diagnosed with small or medium vasculitis can be classified as
    MPA with a cumulative score of ≥ 5 .
    When testing these criteria in the validation dataset, the sensitivity was 91% ( 95% CI 85% to 95% ) and the specificity was 94% ( 95% CI 92% to 96% ) .


      Conclusions: The 2022 American College of Rheumatology / Consortium of European Associations of Rheumatology MPA classification criteria are now validated and available for clinical research
    .

      Conclusions: The 2022 American College of Rheumatology / Consortium of European Associations of Rheumatology MPA classification criteria are now validated and available for clinical research
    .

     

     

    Source:

    Suppiah R, Robson JC, Grayson PC THE DCVAS INVESTIGATORS , et al .
    2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for microscopic polyangiitis.
    Annals of the Rheumatic Diseases  2022; 81: 321-326.

    Suppiah R, Robson JC, Grayson PC THE DCVAS INVESTIGATORS , et al .
    2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria for microscopic polyangiitis.
    , et al Annals of the Rheumatic Diseases  Annals of the Rheumatic Diseases  2022; 81: 321-326.
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