Anti-Neutrophil Cytoplasmic Antibody Vasculitis in Pediatric Patients: Is the Incidence Rising?

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DOI: 10.4236/ojneph.2012.22003    2,676 Downloads   5,765 Views   Citations

ABSTRACT

Objectives: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune disease usually seen in middle-aged and older adults but which is rare in children and adolescents. We sought to determine if there has been a change in the incidence of this disorder. Methods: Single-center, retrospective review. Results: Over the last 2 years, we have encountered a striking increase in the frequency of this disease in pediatric patients. All eight patients seen during this period had renal involvement and 5 patients rapidly progressed to end stage kidney disease. The prognosis was worse in younger patients, those with microscopic polyangiitis, and those with chronic kidney damage in the diagnostic renal biopsy. Conclusions: We report these observations to highlight this change in the epidemiology of ANCA-associated vasculitis and to promote earlier recognition and treatment of this severe form of glomerulonephritis.

Cite this paper

C. Sethna, R. Frank, L. Infante, B. Gottlieb, A. Eberhard, X. Wang and H. Trachtman, "Anti-Neutrophil Cytoplasmic Antibody Vasculitis in Pediatric Patients: Is the Incidence Rising?," Open Journal of Nephrology, Vol. 2 No. 2, 2012, pp. 19-22. doi: 10.4236/ojneph.2012.22003.

References

[1] R. J. Falk and J. C. Charles Jennette, “ANCA Disease: Where Is This Field Heading?” Journal of the American Society of Nephrology, Vol. 21, No. 5, 2010, pp. 745-752. doi:10.1681/ASN.2009121238
[2] A. E. Berden, F. Ferrario, E. Christian Hagen, D. R. Jayne, J. Charles Jennette, K. Joh, I. Neumann, L. H. No?l, C. D. Pusey, R. Waldherr, J. A. Bruijn and I. M. Bajema, “Histopathologic Classification of ANCA-Associated Glomerulonephritis,” Journal of the American Society of Nephrology, Vol. 21, No. 10, 2010, pp. 1628-1636. doi:10.1681/ASN.2010050477
[3] C. E. Rodrigues, M. R. Callado, C. A. Nobre, F. E. Moura, R. M. Vieira, L. A. de Albuquerque and W. P. Vieira, “Wegener’s Granulomatosis: Prevalence of the Initial Clinical Manifestations—Report of Six Cases and Review of the Literature,” Revista Brasileira de Reumatologia, Vol. 50, No. 2, 2010, pp. 150-164. doi:10.1590/S0482-50042010000200005
[4] R. Coppo, P. Cirina, A. Amore, R. A. Sinico, A. Radice and C. Rollino, “Properties of Circulating IgA Molecules in Henoch Schonlein Purpura Nephritis with Focus on Neutrophil Cytoplasmic Antigen IgA Binding (IgAANCA): New Insight into a Debated Issue. Italian Group of Renal Immunopathology Collaborative Study on Henoch Schonlein Purpura in Adults and Children,” Nephrology Dialysis Transplantation, Vol. 12, No. 11, 1997, pp. 2269-2276. doi:10.1093/ndt/12.11.2269
[5] S. Grisaru, G. W. Yuen, P. M. Miettunen and L. A. Hamiwka, “Incidence of Wegener’s Granulomatosis in Children,” The Journal of Rheumatology, Vol. 37, No. 2, 2010, pp. 440-442. doi:10.3899/jrheum.090688
[6] D. A. Cabral, A. G. Uribe, S. Benseler, K. M. O’Neil, P. J. Hashkes, G. Higgins, A. S. Zeft, D. J. Lovell, D. J. Kingsbury, A. Stevens, et al., “Classification, Presentation, and Initial Treatment of Wegener’s Granulomatosis in Childhood,” Arthritis Rheum, Vol. 60, No. 11, 2009, pp. 34133424,. doi:10.1002/art.24876
[7] M. Shimizu, T. Sekiguchi, et al., “A Case of a 6-Year Old Girl with Anti-Neutrophil Cytoplasmic AntibodyNegative Pauci-Immune Crescentic Glomerulonephritis,” Clinical and Experimental Nephrology, Vol. 15, No. 4, 2011, pp. 596-601. doi:10.1007/s10157-011-0423-3
[8] R. Kain, M. Exner, R. Brandes, et al., “Molecular Mimicry in Pauci-Immune Focal Necrotizing Glomerulonephritis,” Nature Medicine, Vol. 14, No. 10, 2008, pp. 1088-1096. doi:10.1038/nm.1874
[9] A. J. Roth, M. C. Brown, R. N. Smith, A. K. Badwar, et al., “Anti-LAMP-2 Antibodies Are Not Prevalent in Patients with Antineutrophil Cytoplasmic Autoantibody Glomerulonephritis,” Journal of the American Society of Nephrology, Vol. 23, No. 5, 2012, pp. 545-555.
[10] N. Arulkumaran, S. Jawad, S.W. Smith, L. Harper, P. Brogan, C. D. Pusey and A. D. Salama, “Long-Term Outcome of Paediatric Patients with ANA Vasculitis,” Pediatric Rheumatology Online Journal, Vol. 9, 2011, p. 12. doi:10.1186/1546-0096-9-12
[11] A. Casian and D. Jayne, “Plasma Exchange in the Treatment of Wegener’s Granulomatosis, Microscopic Polyangiitis, Churg-Strauss Syndrome and Renal Limited Vasculitis,” Current Opinion in Rheumatology, Vol. 23, No. 1, 2011, pp. 12-17. doi:10.1097/BOR.0b013e32834120c1
[12] R. B. Jones, J. Willem Cohen Tervaert, T. Hauser, R. Luqmani, M. D. Morgan, C. A. Peh, et al., “Rituxamab Versus Cyclophosphamide in ANCA-Associated Renal Vasculitis,” The New England Journal of Medicine, Vol. 363, 2010, pp. 211-220. doi:10.1056/NEJMoa0909169
[13] J. H. Stone, P. A. Merkel, et al., “Rituximab Versus Cyclophosphamide for ANCA-Associated Vasculitis,” The New England Journal of Medicine, Vol. 363, 2010, pp. 221-232. doi:10.1056/NEJMoa0909905

  
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