Scleritis in granulomatosis with polyangiitis: clinical study and follow-up of 43 cases

• DOI: 10.3760/cma.j.issn.1007-7480.2017.10.006
• Publication Date: 2017-10-15
• Authors: Yuan Gao; Zhengang Wang; Nan Chen; Cui Li; Yanni Wang
• Keywords: Granulomatosis with polyangiitis; Microscopic polyangiitis

Objective To investigate the clinical characteristics of granulomatosis with polyangiitis (GPA) patients scleritis.

Methods The completed data 102 GPA from March 2012 to July 2016 in Capital Medical University, Tong Ren Hospital were collected. Altogether 43 scleritis enrolled, and analyzed respectively. The t test, Mann-Whitney U test andχ2 testwere used analyze data.

Results The most common ocular manifestation was scleritis. incidence renal damage (37.2% vs 11.9%, χ2=9.148, P=0.002), disease activity (BVAS/GPA score 8.9 5.1, Z=7.847, P=0.000), DEI (7 4, Z=5.919, inflammation index (56 mm/1 h 36 h, Z=2.456, P=0.016; CRP 51 mg/L 8 mg/L, Z=3.748, neutrophil percent (70% 61%, t=3.993, complement 3(1.2 g/L 1.0 g/L, t=2.652, P=0.009), plasma fibrinogen (3.5 3.3 t=3.947, D-dimmer (0.5 FEU 0.3 FEU, Z=2.371, P=0.018) ANCA positive rate (90.7% 57.6%, χ2=13.369, P=0.000) higher scleritis, as well a poor prognosis (2009-FFS 0.4 0.1, Z=2.600, P=0.009). However, lower subglottic involvement detected group (4.7% 20.3%, χ2=5.169, P=0.023). There no significant differences between episcleritis feature, activity, inflammatory prognosis. Aggressive immunosuppres-sive treatment appropriate for Tumor necrosis factor (TNF)-аinhibitor an effective treatment.

Conclusion GPA usually suffered index, broader DEI, poorer should be initiated order achieve remission. Subglottic is less phenotype not associated severity.

Key words: Scleritis; Granulomatosis polyangiitis; Biological agents