Patients with ANCA-Associated Glomerulonephritis and Connective Tissue Diseases: A Comparative Study from the Maine-Anjou AAV Registry

Background and objectives: The overlap between antineutrophil cytoplasmic antibody (ANCA) associated glomerulonephritis (ANCA-GN) and connective tissue diseases (CTD) has been reported mainly as case series in the literature. Frequency of this association, as well as presentation and outcomes are un...

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Main Authors: Fanny Guibert, Anne-Sophie Garnier, Samuel Wacrenier, Giorgina Piccoli, Assia Djema, Renaud Gansey, Julien Demiselle, Benoit Brilland, Maud Cousin, Virginie Besson, Agnès Duveau, Khuzama El Nasser, Jean-Philippe Coindre, Anne Croue, Jean-Paul Saint-André, Alain Chevailler, Jean-François Subra, Jean-François Augusto
Format: Article
Language:English
Published: MDPI AG 2019-08-01
Series:Journal of Clinical Medicine
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Online Access:https://www.mdpi.com/2077-0383/8/8/1218
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Summary:Background and objectives: The overlap between antineutrophil cytoplasmic antibody (ANCA) associated glomerulonephritis (ANCA-GN) and connective tissue diseases (CTD) has been reported mainly as case series in the literature. Frequency of this association, as well as presentation and outcomes are unknown. Materials and Methods: Patients from the Maine-Anjou ANCA-associated vasculitides (AAV) registry with ANCA-GN diagnosed between 01/01/2000 and 01/01/2018, ANCA positivity, and at least six months of follow-up, were included. Results: 106 out of 142 patients fulfilled the inclusion criteria and were analyzed. CTD was present at ANCA-GN diagnosis in 16 (15.1%) patients. The most common CTD were rheumatoid arthritis, Sjogren syndrome and systemic sclerosis. Compared to the control group, females were more represented in the CTD group (75%, <i>p</i> = 0.001). Renal presentation was comparable between groups, including the pathological analysis of renal biopsies. Patients of CTD group presented a higher rate of non-renal relapse (25% versus 7.7%, <i>p</i> = 0.037), and experienced more frequently a venous thrombotic event (31.2% versus 10%, <i>p</i> = 0.021). No difference between groups was observed according to major outcomes. Conclusion: Association between CTD and ANCA-GN is not a rare condition and predominantly affects females. While AAV presentation is not significantly different, CTD patients experience more frequently non-renal relapse and venous thrombotic events.
ISSN:2077-0383