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Is granulomatosis with polyangiitis in Asia different from the West?
Author(s) -
Naidu Godasi S. R. S. N. K.,
Misra Durga Prasanna,
Rathi Manish,
Sharma Aman
Publication year - 2019
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13398
Subject(s) - granulomatosis with polyangiitis , medicine , dermatology , vasculitis , pathology , disease
Abstract The incidence and clinical features of antineutrophil cytoplasmic antibody ( ANCA ) associated vasculitis ( AAV ) have been shown to vary according to geographical areas, with granulomatosis with polyangiitis ( GPA ) being more common in northern Europe and microscopic polyangiitis ( MPA ) being more common in Asian countries. The annual incidence of GPA among Asians varies between 0.37/million to 2.1/million population. The prevalence of GPA has been estimated to be 1.94/100 000 in a Chinese population. Polymorphisms in class II major histocompatibility genes and ETS 1 proto‐oncogene has been shown in Asian patients with GPA . There is a difference in mean age at onset and proteinase 3 ( PR 3) or myeloperoxidase ( MPO ) positivity in GPA patients from different Asian countries. Those from India had mean age of 40 years and those from Japan had mean age of 65 years. Sixty percent of GPA patients from China and Japan were MPO ANCA positive while the majority of patients from India and Korea were PR 3 positive. Geographical variation with lower frequency of renal involvement in Indian studies and higher frequency in Chinese patients has also been noted. Treatment outcomes have been similar to those reported from other parts of the world. Remission was achieved in about two‐thirds of patients while relapses were noted in one‐third to half of the patients. Apart from minor differences in the organ systems involved, MPO ‐ ANCA GPA and PR 3‐ ANCA GPA had similar rates of remission and relapses.